Long-term oncologic outcomes of liver resection for hepatocellular carcinoma in adolescents and young adults: A multicenter study from a hepatitis B virus-endemic area.
BACKGROUND
Hepatocellular carcinoma (HCC) is common among adolescents and young adults (AYAs) in areas with endemic hepatitis B virus infection. We sought to characterize clinical features and long-term outcomes among AYAs versus older adults (OAs) who underwent HCC resection.


METHODS
From a Chinese multicenter database, patients were categorized as AYA (aged 13-39 years) versus OA (aged ≥40 years). Patient clinical features, perioperative outcomes, overall survival (OS) and time-to-recurrence (TTR) were compared. Multivariable Cox-regression analyses were performed to identify the impact of age on OS and TTR.


RESULTS
Among 1952 patients, 354(22.2%) were AYAs. AYAs were less likely to have cirrhosis yet were likely to have advanced tumor pathological characteristics than OAs. Postoperative morbidity and mortality were comparable. Compared with OAs, AYAs had a comparable OS but a decreased TTR. Multivariable analyses identified that young age (<40 years) was independently associated with poorer TTR.


CONCLUSIONS
Compared with OAs, AYAs had a higher incidence of recurrence following liver resection among patients with HCC, suggesting that enhanced surveillance for postoperative recurrence may be required among AYAs.
['Diao|Yong-Kang|YK|', 'Liu|Jun-Wei|JW|', 'Wu|Han|H|', 'Wang|Ming-Da|MD|', 'Fan|Xin-Ping|XP|', 'Chen|Ting-Hao|TH|', 'Wang|Jian-Yu|JY|', 'Zhou|Ya-Hao|YH|', 'Gu|Wei-Min|WM|', 'Wang|Hong|H|', 'Li|Jie|J|', 'Liang|Ying-Jian|YJ|', 'Chen|Zhi-Yu|ZY|', 'Lau|Wan Yee|WY|', 'Liang|Lei|L|', 'Li|Chao|C|', 'Zhang|Cheng-Wu|CW|', 'Shen|Feng|F|', 'Huang|Dong-Sheng|DS|', 'Yang|Tian|T|']
D000293:Adolescent D000328:Adult D006528:Carcinoma, Hepatocellular D002681:China D005260:Female D006509:Hepatitis B D006801:Humans D008113:Liver Neoplasms D008297:Male D009364:Neoplasm Recurrence, Local D012307:Risk Factors D015996:Survival Rate
Hepatocellular carcinoma Adolescents and young adults Overall survival Time-to-recurrence Hepatectomy