Table 1.
Clinical characteristic of children with hepatocellular carcinoma in series from East
| Study → Ref. (yr) | Moore et al[7] (2004) | Wang et al[38] (2017) | Chen et al[10,29] (1988, 1998) | Hsu et al[28] (1987) | Zhang et al[12] (2013) | Arikan et al[13] (2006) | Palaniappan et al[26] (2016) |
| Region | South Africa | China | Taiwan | Taiwan | China | Turkey | India |
| No. of subjects | 68 | 65 | 44, 55 | 51 | 45 | 13 (Incidental diagnosis in 3) | 12 (8 diagnosed in explant livers) |
| Males (%) | 68 (78 in HBV subgroup) | 80 | Males dominated | 77 | 93 | 46 | 75 |
| Age (yr) | Mean 10.5 | Median 17 (8-20) | - | Mean 11 (4-15) | Mean 13.5 (3-18) | 6.4 ± 4.8 | Median 5.9 (1.6-15.4) |
| Age-group (n or %) | 91% > 6 yr of age | - | - | 39% < 9 yr of age | - | - | < 5 yr→3 5-10 yr→7 > 10 yr→2 |
| Size (cm) | - | 10.2 ± 4.1 | - | - | > 5 cm in 73% > 10 cm in 67% | Median 3.4 (0.5-8) | 22.5 (2-40) |
| Multifocality | - | 62% | 62% | - | 56% Satellite lesions in 18% | 92% Median number of nodules 3 (1-10) | 42% Median number of nodules 1 (1-5) |
| Etiology | 67% HBV | 82% HBV | 100% HBV | 100% HBV | 71% HBV | 6 Tyr 6 HBV 1 GSD1 | 5 Tyr 2 BA 1 BSEP 1 MDR3 1 NSPILBD 1 PSC 1 Caroli’s |
| Histology (n or %) | HCC 87% FLHCC 13% | - | - | - | - | Well diff 2 Mod diff 4 Poorly diff 6 | Well diff 8 Mod diff 4 (High grade dysplasia or nodules in adjoining liver in 50%) |
| Cirrhosis | - | - | 71%, 68% | 74% (95%) in < 9 yr of age | 47% Child A/B/C 32/8/5 | 100% Mean CTP 11.1 ± 3.1 and PELD 19.7 ± 2.4 (1-44) | - |
| AFP | High in 69% | > 25 ng/mL in 91% | - | - | 93999 ± 31228 ng/mL High in 87% | 8000-250000 ng/dL High in 92% | Median AFP 7.3(1.2-28000) IU/L High AFP (> 100 IU/L) in 42% |
| Extent or stage (n or %) | - | TNM Stage III/IV in 74% | - | Advance stage in 98% | - | TNM stage I (20%), IV (80%) Advance disease in 92% | - |
| Vascular invasion | - | 31% | 42% PV 17% IVC | - | 47% | 54% | 17% |
| Metastases | - | 17% | 29% | - | 24% | 0 | - |
| Resectability | - | 40% | < 10%, 18% | 13% | 27% | NA | NA |
| Outside Milan | NA | NA | NA | NA | NA | NA | NA |
AFP: Alpha-fetoprotein; BA: Biliary atresia; BSEP: Bile salt export pump deficiency (PFIC2); diff: Differentiated; FLHCC: Fibrolamellar variant of HCC; GSD: Glycogen storage disease; HBV: Hepatitis-B virus; IVC: Inferior vena cava; LT: Liver transplantation; MDR3: Multidrug resistance protein3 deficiency (PFIC3); NA: Not assessed; NSPILBD: Non-syndromic paucity of bile ducts; PRETEXT: Pretreatment tumor extent evaluation; PSC: Primary sclerosing cholangitis; PV: Portal vein; TNM: Tumor node metastasis stage; Tyr: Tyrosinemia; Mod: Moderately.