Clinicopathological characteristics of early-onset hepatocellular carcinoma and its comparison with non-early-onset hepatocellular carcinoma

Abstract

Abstract: Objective To compare the clinicopathological features of HBV-related early-onset HCC(EO-HCC) and late-onset HCC(LO-HCC), and to clarify the clinical features of EO-HCC, so as to provide guidance for clinical management. Methods 113 HCC patients treated between June 2016 and December 2021 in Dongguan Songshan Lake Central Hospital were collected and divided into EO-HCC and LO-HCC. Traditional open radical resection of liver cancer was performed in the included cases, and TACE was performed in some cases according to the postoperative situation. During the 3-year follow-up, patients underwent regular CT/MRI examination and recorded the all-cause death or follow-up to the deadline as the end point. Breslow method was used to compare the overall survival rate between groups through K-M survival curve. Results There were 46 cases of EO-HCC and 67 cases of LO-HCC. The tumor diameters in EO-HCC group and LO-HCC group were (3.8±1.1) cm and (4.7±1.4) cm, and the difference was statistically significant (P<0.05). On the other hand, there were significant differences in T1/T2 and T3/T4 between EO-HCC and LO-HCC groups (P<0.05). The positive rates of MVI and AFP in EO-HCC patients were 22 cases (47.8%) and 24 cases (52.2%). which were significantly higher than those in LO-HCC [19 cases (28.3%) and 22 cases (32.8%), P<0.05]. We compared the difference of clinical outcomes between EO-HCC and LO-HCC using the K-M survival curve, there was no significant difference in the 1-year, 3-year and 5-year survival rates between EO-HCC and LO-HCC (P>0.05). Tumor stage (T3/T4 stage), tumor differentiation degree (low differentiation), MVI positive and postoperative TACE were independent factors affecting the prognosis of HCC. Among them, MVI positive was an independent risk factor for poor prognosis (P<0.05), while postoperative TACE was a protective factor (P<0.05). Conclusion EO-HCC is more likely to have increased AFP and positive MVI than LO-HCC, but the former has better tumor diameter and tumor differentiation. The overall clinical outcomes of EO-HCC and LO-HCC are similar. The COX regression analysis shows that MVI positive is an independent risk factor for poor prognosis of HCC, while postoperative TACE is a protective factor. EO-HCC needs active postoperative anti-tumor treatment.

Key words: Early-onset hepatocellular carcinoma, Microvascular invasion, Transarterial chemoembolization

ZHU Ran, CHEN Shu-rao, ZOU Meng-qi, YANG Yu-feng. Clinicopathological characteristics of early-onset hepatocellular carcinoma and its comparison with non-early-onset hepatocellular carcinoma[J]. Chinese Hepatolgy, 2025, 30(8): 1093-1096.

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