Viral Hepatitis
Copyright ©The Author(s) 2005. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 14, 2005; 11(34): 5289-5294
Published online Sep 14, 2005. doi: 10.3748/wjg.v11.i34.5289
Comparison of childhood hepatic malignancies in a hepatitis B hyper-endemic area
Jeng-Chang Chen, Ming-Ling Chang, Jer-Nan Lin, Hong-Shiee Lai, Chiu-Chiang Chen, Wei-Jao Chen, Wen-Tsung Hung
Jeng-Chang Chen, Jer-Nan Lin, Department of Surgery, Chang Gung Children’s Hospital, Taoyuan, Taiwan, China
Ming-Ling Chang, Division of Gastroenterology, Department of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan, China
Hong-Shiee Lai, Chiu-Chiang Chen, Wei-Jao Chen, Wen-Tsung Hung, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan, China
Author contributions: All authors contributed equally to the work.
Supported by Chang Gung Children’s Hospital, Taoyuan, Taiwan, China, CMRPG 33063
Correspondence to: Jer-Nan Lin, Department of Surgery, Chang Gung Children’s Hospital, 5 Fu-Shin Street, Kweishan, 333, Taoyuan, Taiwan, China. bx9619@cgmh.org.tw
Telephone: +886-3-3281200-8227 Fax: +886-3-3287261
Received: January 3, 2005
Revised: February 13, 2005
Accepted: February 18, 2005
Published online: September 14, 2005
Abstract

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. Demog-raphic, laboratory and radiological data, and survival curves were statistically compared.

RESULTS: HCC clinically differed from HB in mean age (10.6 vs 2.5 years; P < 0.001), status of hepatitis B infection (56/56 vs 4/35, 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 (10/56 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: HCC and HB were preliminarily distinguishable by some clinical 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.

Keywords: Chemotherapy, Children, Hepatitis B, Hepato-blastoma, Hepatocellular carcinoma