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.

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From: The American Journal of Surgery(Vol. 222, Issue 4)
Publisher: Elsevier B.V.
Document Type: Report
Length: 539 words

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Keywords Hepatocellular carcinoma; Hepatectomy; Adolescents and young adults; Overall survival; Time-to-recurrence Highlights * Adolescents and young adults (AYA, 13--39 years) undergoing liver resection for hepatocellular carcinoma (HCC) were less often to have cirrhosis but more likely to have advanced tumor pathological characteristics than older adults (OA, [greater than or equal to] 40 years). * Postoperative morbidity and mortality were comparable between AYAs and OAs with HCC. * Young age ( Abstract 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 [greater than or equal to]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 ( 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. Author Affiliation: (a) Department of Hepatobiliary Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People's Hospital (People's Hospital of Hangzhou Medical College), Hangzhou, Zhejiang, China (b) School of Clinical Medicine, Hangzhou Medical College, Hangzhou, Zhejiang, China (c) Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), Shanghai, China (d) Department of General Surgery, Pingxiang Mining Group General Hospital, Jiangxi, China (e) Department of General Surgery, Ziyang First People's Hospital, Sichuan, China (f) Department of Hepatobiliary Surgery, Pu'er People's Hospital, Yunnan, China (g) The First Department of General Surgery, The Fourth Hospital of Harbin, Heilongjiang, China (h) Department of General Surgery, Liuyang People's Hospital, Hunan, China (i) Department of Hepatobiliary Surgery, Fuyang People's Hospital, Fuyang, Anhui, China (j) Department of Hepatobiliary Surgery, The First Affiliated Hospital of Harbin Medical University, Heilongjiang, China (k) Department of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China (l) Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China * Corresponding author. Department of Hepatobiliary Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People's Hospital (People's Hospital of Hangzhou Medical College), Hangzhou, Zhejiang, China. Article History: Received 14 January 2021; Revised 8 February 2021; Accepted 5 March 2021 (footnote)1 These authors contributed equally to this work. Byline: Yong-Kang Diao (a,b,1), Jun-Wei Liu (a,b,1), Han Wu (c,1), Ming-Da Wang (c,1), Xin-Ping Fan (d,1), Ting-Hao Chen (e), Jian-Yu Wang (e), Ya-Hao Zhou (f), Wei-Min Gu (g), Hong Wang (h), Jie Li (i), Ying-Jian Liang (j), Zhi-Yu Chen (k), Wan Yee Lau (c,l), Lei Liang (a,b), Chao Li (a,b), Cheng-Wu Zhang (a), Feng Shen (c), Dong-Sheng Huang [huangdongshengzj@hotmail.com] (a,b,**), Tian Yang [yangtianzry@hotmail.com] (a,b,c,*)

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Gale Document Number: GALE|A675616044