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Is Hepatocellular Carinoma in Young Patients More Aggressive than Old Patients?

대한간암연구학회지 2009년 9권 1호 p.24 ~ 28
이정민, 김도영,
소속 상세정보
이정민 ( Lee Jung-Min ) - 연세대학교 의과대학 내과학교실
김도영 ( Kim Do-Young ) - 연세대학교 의과대학 내과학교실

Abstract


In Korea, hepatocellular carcinoma (HCC) is a fourth leading malignancy with poor prognosis of 5 year survival reaching just 18.9%. The peak incidence is 6th decade and the incidence drops with decreasing age. However, young patients with HCC are not uncommonly encountered in clinical practice, and notably, even though managements with all available modalities are undertaken in these patients, the prognosis does not seem to be better. As such, many physicians feel that the behavior of HCC in young patients takes a more aggressive course than that in old patients. From this perspective, we performed a systemic review of previous literatures focusing on the question whether or not HCC in young patients is more aggressive; it was found that young patients with HCC had presentation of more advanced stage, more preserved liver function, but poor or equivocal survival rate. In the multivariate analysis, however, the poor outcome resulted not from young age, but from advanced stage, which was supported by similar or better outcome when the prognosis was compared with the same stage between young and old patients. Consequently, it could be inferred that an earlier detection of the tumor through earlier starting point of surveillance might improve the prognosis of young patients with HCC. However, a matter of cost-effectiveness should also be considered, which necessitates a further analysis on this issue.

키워드

Hepatocelluar carcinoma;Young patient;Prognosis

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