Hepatocellular carcinoma in childhood: clinical manifestations and prognosis

Article Abstract:

Liver cancer is uncommon among children, and in most parts of the world a child is more likely to develop the form of liver cancer called hepatoblastoma than hepatocellular carcinoma. However, in parts of the world where infection with hepatitis B virus is common, such as China, the situation is reversed and hepatocellular carcinoma is the form of liver cancer that is more common among children. A review of 71 cases of hepatocellular carcinoma in children in Taiwan has allowed the tabulation of features of this disease. Generally, abdominal pain and the development of an abdominal mass were the first indications that something was wrong. Unfortunately, the result is that most children already had advanced cancer at the time of initial diagnosis. Boys with hepatocellular carcinoma were found to outnumber girls by over three to one. The prognosis for children with hepatocellular carcinoma seems particularly bleak, and in the present series of patients only 10 percent survived the first year after diagnosis. Not all of the 71 patients could be followed-up successfully, but of the 49 who were, only two were alive more than five years after their diagnosis of hepatocellular carcinoma. Both of these children had successful surgical treatment for their cancer; one of the surviving pair had a large tumor mass that required several operations. Although the prognosis for children with hepatocellular carcinoma is grim, the most important features appear to be the absence of jaundice and cancer that is amenable to surgical resection. It is clear, therefore, that in such cases every effort should be made for surgical treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Surgery

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Influence of hepatitis B virus infection and age on mode of growth of hepatocellular carcinoma

Article Abstract:

The cause of hepatocellular carcinoma, a form of liver cancer, may not be the same around the world. In some places, such as Africa and Japan, hepatocellular carcinoma is strongly associated with infection with the hepatitis B virus. This association is less striking for residents of western nations. A study of 465 Japanese patients with hepatocellular carcinoma was undertaken to determine if the presence of hepatitis B virus surface antigen, a protein component of the virus' structure abbreviated HBsAg, was related to the severity of the liver cancer. Such a study would not have been possible only a few years ago; however, with the advent of modern medical imaging techniques, it is now possible to accurately determine the distribution and degree of spread of liver cancer while the patient is alive. The researchers analyzed the spread of cancer into the portal vein, which is the large vessel that carries blood into the liver from the intestines. They found that the liver cancer was more extensive and the portal vein more likely to be involved in patients who had HBsAg in their blood. The researchers also found that more extensive disease was more common among the younger patients than the older. This influence of age on the course of disease was independent of whether HBsAg was present or not. In general, the prognosis of hepatocellular carcinoma in younger patients is very poor. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Maternal transmission of hepatitis B virus in childhood hepatocellular carcinoma

Article Abstract:

Hepatitis B virus (HBV) infections have been associated with an increased risk for developing a type of liver cancer, hepatocellular carcinoma. In Taiwan, the prevalence of HBV infection is high, where hepatocellular carcinoma affects adults more often than children. The relationship of HBV to hepatocellular carcinoma in children was investigated in 51 children diagnosed with this disease. The family members of the children with liver cancer, who could be carriers of HBV, were also examined. A test for hepatitis B virus antigen, which indicates hepatitis B exposure, was positive in 39 patients. Thirty-one mothers (of 33 liver cancer patients) and two pairs of siblings, out of 29, tested positive for HBV antigen. Both the mothers and siblings of children with hepatocellular carcinoma had higher positivity rates than the mothers and siblings of children identified as HBV carriers. This was not true of the fathers of children with hepatocellular carcinoma. It was concluded that the time it takes from infection to the development of the cancer is shorter in children than adults. In Taiwan an HBV infection in mothers is the major mode of transmission of HBV to children with hepatocellular carcinoma. Transmission of HBV probably occurs around the time of birth or in early childhood. Widespread vaccination may help to lower the incidence of hepatocellular carcinoma. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Measurement, Maternal-fetal exchange, Physiological aspects, Development and progression, Disease transmission, Hepatitis B virus, Hepatitis associated antigen, Hepatitis B e-antigen

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