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Paediatric hepatoblastoma and hepatocellular carcinoma:
retrospective study
KL Chan, ST Fan, PKH Tam, AKS Chiang, GCF Chan,
SY Ha
Centre for the Study of Liver Disease, The University of Hong Kong,
Queen Mary Hospital, 102 Pokfulam Road, Hong Kong
OBJECTIVES. To compare and contrast clinical characteristics
and outcomes of hepatoblastoma or hepatocellular carcinoma in paediatric
patients.
DESIGN. Retrospective study.
SETTING. University teaching hospital, Hong Kong.
PATIENTS AND METHODS. Medical records of 22 paediatric patients
with hepatoblastoma (n=11) or hepatocellular carcinoma (n=11) admitted
to Queen Mary Hospital between 1989 and 2000 were reviewed. Data
gathered included demographic data, results of liver function tests,
hepatitis A, B, and C titres, and alpha-foetoprotein levels, and
imaging studies including chest X-ray, ultrasound study, computed
tomography scan, and magnetic resonance imaging/hepatic angiogram
for tumour staging and resectability.
RESULTS. The mean age of patients with hepatoblastoma was 18 months
(range, 5 months to 3 years), while that of patients with hepatocellular
carcinoma was 10.2 years (range, 2 to 16 years). Females predominated
in the hepatoblastoma group (female:male, 8:3) and males in the
hepatocellular carcinoma group (male:female, 10:1). None of the
patients with hepatoblastoma were hepatitis B surface antigen positive,
in contrast to 64% of the hepatocellular carcinoma group. Only 45%
of the hepatocellular carcinomas were resectable at presentation
and this figure remained unchanged following chemotherapy. A total
of 91% of hepatoblastomas were resectable, four at presentation,
and a further six after chemotherapy. Tumour rupture was more common
in patients with hepatoblastoma than in those with hepatocellular
carcinoma (36% versus 9% of cases, respectively). Mortality rates
were considerably higher among the hepatocellular carcinoma group
than the hepatoblastoma group in this series.
CONCLUSION. Childhood hepatoblastoma and hepatocellular carcinoma
differ with respect to age and tumour stage at presentation, hepatatis
B surface antigen status, tendency to rupture, chemosensitivity,
and prognosis.
Hong Kong Med J 2002;8:13-7
Key words: Carcinoma, hepatocellular; Child; Hepatoblastoma;
Infant; Liver neoplasms
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