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Oral Presentation - 82
Clinical Outcomes and Prognostic Factors in Pediatric HCC: 24-Year Retrospective Study in South Korea
Sujin Gang 1, Ju Yeon Lee 2, Seo-Hee Kim 3, Wooim Baek 4, Jung-Man Namgoong 5
1 Division of Pediatric Surgery, Department of Surgery, Ewha Womans University Seoul Hospital
2 Department of Pediatric Surgery, Chonnam National University Hospital
3 Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Chonnam National University Hospital
4 Department of Pediatrics, Asan Medical Center Children’s Hospital
5 Division of Pediatric Surgery, Department of Surgery, Asan Medical Center
Importance: Pediatric hepatocellular carcinoma (pHCC) is a rare, aggressive malignancy, distinct from adult hepatocellular carcinoma (HCC).
Objective: This retrospective study aimed to investigate the clinical outcomes, pathological features, and prognostic factors of pHCC in a South Korean population over a 24-year period.
Design, setting and Participants: This single-center retrospective study included 50 patients (<19 years old) diagnosed and treated for pHCC at Asan Medical Center (1990–2023). Tumors were subclassified as conventional HCC or hepatocellular neoplasm not otherwise specified (HCN-NOS) based on histological and immunohistochemical re-evaluations. Kaplan–Meier and Cox proportional hazards models were used to identify prognostic factors.
Exposures: To identify factors influencing clinical outcomes, a comprehensive review of clinical data, imaging findings, and pathological results was conducted, and this information was incorporated into the analysis.
Main Outcome and Measure: Clinical outcomes were assessed by collecting data on surgery, follow-up, survival status, recurrence, and mortality. Overall survival (OS) was defined as the time from surgery to death from any cause. Event-free survival (EFS), defined as survival without events for 3 years post-surgery, was also assessed. Various analyses were performed to identify risk factors, addressing the statistical limitations of the small sample size.
Results: Among the 50 patients, 45 had conventional HCC and 5 had HCN-NOS. Hepatitis B virus-related HCC (38%) was significantly associated with worse survival. High serum alpha-fetoprotein (AFP) levels (>1000 ng/mL), portal vein invasion, metastases, and resectability were strongly correlated with survival outcomes. HCN-NOS showed rapid progression and poor prognosis, emphasizing the need for multidisciplinary diagnostic and therapeutic approaches.
Conclusions and Relevance: Our findings underscore the importance of tumor burden and operability in pHCC outcomes, highlighting the need for early diagnosis and risk stratification. The aggressive progression of HBV-related HCC necessitates proactive cancer surveillance, even after hepatitis B virus seroconversion.