Hepatocellular carcinoma in non-hepatitis B virus endemic areas is rare in patients younger than 40 years of age. The aim of this study was to characterize young patients in a large German cohort in comparison with older patients with regard to underlying liver disease, clinical management, and survival.
We analyzed the clinical data and medical records of 1108 consecutive patients with confirmed hepatocellular carcinoma. Twenty-five patients (2%) were younger than 40 years of age. We compared this subgroup with patients older than 40 years of age.
Underlying chronic liver disease was less common in young patients and detectable in only 56% of patients. Fibrolamellar carcinoma was more frequent in young versus old patients (20% vs. 0.7%; P<0.001). There was a trend toward more potentially curative treatment options in young patients, and overall survival was longer in the young group compared with older patients (56.0 vs. 15.2 mo; P=0.048).
This western cohort of young patients is distinctly different from described Asian cohorts, especially with regard to a lower rate of underlying liver disease and particularly hepatitis B virus. Young patients had a better overall survival than older patients.
Departments of *Internal Medicine I
†Diagnostic and Interventional Radiology
‡Transplantation and Hepatobiliopancreatic Surgery, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
This work was not supported by any grants or financial support.
A.W., M.S., P.R.G., and M.-A.W. have received lecture and travel fees from Bayer Vital, Leverkusen, Germany. The other authors declare that they have nothing to disclose.
Reprints: Ina M. Niederle, MD, Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55101 Mainz, Germany (e-mail: email@example.com).
Received November 15, 2011
Accepted May 23, 2012