摘要
AIM: To examine the differences of clinical behaviors between hepatocellular carcinomas (HCC) and hepatoblastomas (HB) in children.METHODS: From 1979 to 1997, we collected 73 HCC and 54 HB from two major medical centers in Taiwan. Demographic, laboratory and radiological data, and survival curves were statistically compared.RESULTS: HCC clinically differed from HB in mean age (10.6 vs2.5 years; P<0.001), status of hepatitis B infection (56/56 vs4/35, P<0.001) and accompanying liver cirrhosis (26/40 vs 0/30, P<0.001), portal vein thrombi (22/56 vs 5/38, P = 0.006) and para-aortic lymphadenopathy (10/56vs 1/38, P = 0.026). Due to a higher recurrence rate (7/12vs 2/13, P = 0.041), stage I HCC compared poorly in survivals with stage I HB (P= 0.0183). Chemotherapy could only benefit HB as evidenced by 66.7% of resectability conversion and improve survivals for advanced HB, even with unsuccessful conversion. The survival difference between stage I HB and advanced HB with delayed complete resection was of borderline insignificance (P = 0.0507).CONCLUSION: HCC and HB were preliminarily distinguishable by some dinical clues. Delayed resection after chemotherapy was only possible for HB. However, further studies are needed to strengthen our observation that appropriate reliance upon chemotherapy to subsequently resect advanced HB could achieve the comparable survival to that of stage I HB.
AIM: To examine the differences of clinical behaviors between hepatocellular carcinomas (HCC) and hepatoblastomas (HB) in children.
METHODS: From 1979 to 1997, we collected 73 HCC and 54 HB from two major medical centers in Taiwan. Demographic, laboratory and radiological data, and survival curves were statistically compared. RESULTS: HCC clinically differed from HB in mean age (10.6 vs2.5 years; P〈0.001), status of hepatitis B infection (56/56 vs4/35, P〈0.001) and accompanying liver cirrhosis (26/40 vs 0/30, P〈0.001), portal vein thrombi (22156 vs 5/38, P=0.006) and para-aortic lymphadenopathy (10/56 vs 1/38, P=0.026). Due to a higher recurrence rate (7/12 vs 2/13, P=0.041), stage I HCC compared poorly in survivals with stage I HB (P=0.0183). Chemotherapy could only benefit HB as evidenced by 66.7% of resectability conversion and improve survivals for advanced HB, even with unsuccessful conversion. The survival difference between stage I HB and advanced HB with delayed complete resection was of borderline insignificance (P=0.0507).
CONCLUSION: I-ICC and HB were preliminarily distinguishable by some dinical dues. Delayed resection after chemotherapy was only possible for HB. However, further studies are needed to strengthen our observation that appropriate reliance upon chemotherapy to subsequently resect advanced HB could achieve the comparable survival to that of stage I HB.
基金
Supported by Chang Gung Children's Hospital, Taoyuan, Taiwan, China, CMRPG 33063
关键词
儿童
肝疾病
肝细胞癌
乙型肝炎
地区性疾病
Chemotherapy
Children
Hepatitis B
Hepatoblastoma
Hepatocellular carcinoma