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Clinicopathologic Features and Prognosis of Young Patients With Hepatocellular Carcinoma in a Large German Cohort

Niederle, Ina M. MD*; Wörns, Marcus-Alexander MD*; Koch, Sandra*; Nguyen-Tat, Marc MD*; Düber, Christoph MD, PhD; Otto, Gerd MD, PhD; Schuchmann, Marcus MD, PhD*; Galle, Peter R. MD, PhD*; Weinmann, Arndt MD*

Journal of Clinical Gastroenterology: October 2012 - Volume 46 - Issue 9 - p 775–778
doi: 10.1097/MCG.0b013e31826102cc

Goals and Background: 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.

Study: 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.

Results: 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).

Conclusions: 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:

Received November 15, 2011

Accepted May 23, 2012

© 2012 Lippincott Williams & Wilkins, Inc.