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Journal of the Korean Liver Cancer Study Group 2009;9(1):24-28.
Published online June 30, 2009.
Is Hepatocellular Carinoma in Young Patients More Aggressive than Old Patients?
Jung Min Lee, Do Young Kim
Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicin
Correspondence:  Do Young Kim,
Email: dyk1025@yuhs.ac
Abstract
In Korea, hepatocellular carcinoma (HCC) is a fourth leading malignancy with poor prognosis of 5 year survival reaching just 18.9%. The peak incidence is 6th decade and the incidence drops with decreasing age. However, young patients with HCC are not uncommonly encountered in clinical practice, and notably, even though managements with all available modalities are undertaken in these patients, the prognosis does not seem to be better. As such, many physicians feel that the behavior of HCC in young patients takes a more aggressive course than that in old patients. From this perspective, we performed a systemic review of previous literatures focusing on the question whether or not HCC in young patients is more aggressive; it was found that young patients with HCC had presentation of more advanced stage, more preserved liver function, but poor or equivocal survival rate. In the multivariate analysis, however, the poor outcome resulted not from young age, but from advanced stage, which was supported by similar or better outcome when the prognosis was compared with the same stage between young and old patients. Consequently, it could be inferred that an earlier detection of the tumor through earlier starting point of surveillance might improve the prognosis of young patients with HCC. However, a matter of cost-effectiveness should also be considered, which necessitates a further analysis on this issue.
Key Words: Hepatocelluar carcinoma; Young patient; Prognosis
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