Pediatric hepatocellular carcinoma

Table 1 Clinical characteristic of children with hepatocellular carcinoma in series from East

Study → Ref. (yr)	Mooreet al[7](2004)	Wanget al[38](2017)	Chenet al[10,29] (1988, 1998)	Hsuet al[28](1987)	Zhanget al[12](2013)	Arikanet al[13](2006)	Palaniappanet al[26](2016)
Region	South Africa	China	Taiwan	Taiwan	China	Turkey	India
No. of subjects	68	65	44, 55	51	45	13 (Incidental diagnosis in 3)	12 (8 diagnosed in explant livers)
Males (%)	68 (78 in HBV subgroup)	80	Males dominated	77	93	46	75
Age (yr)	Mean 10.5	Median 17 (8-20)	-	Mean 11 (4-15)	Mean 13.5 (3-18)	6.4 ± 4.8	Median 5.9 (1.6-15.4)
Age-group (n or %)	91% > 6 yr of age	-	-	39% < 9 yr of age	-	-	< 5 yr→3 5-10 yr→7 > 10 yr→2
Size (cm)	-	10.2 ± 4.1	-	-	> 5 cm in 73% > 10 cm in 67%	Median 3.4 (0.5-8)	22.5 (2-40)
Multifocality	-	62%	62%	-	56% Satellite lesions in 18%	92% Median number of nodules 3 (1-10)	42% Median number of nodules 1 (1-5)
Etiology	67% HBV	82% HBV	100% HBV	100% HBV	71% HBV	6 Tyr 6 HBV 1 GSD1	5 Tyr 2 BA 1 BSEP 1 MDR3 1 NSPILBD 1 PSC 1 Caroli’s
Histology (n or %)	HCC 87% FLHCC 13%	-	-	-	-	Well diff 2 Mod diff 4 Poorly diff 6	Well diff 8 Mod diff 4 (High grade dysplasia or nodules in adjoining liver in 50%)
Cirrhosis	-	-	71%, 68%	74% (95%) in < 9 yr of age	47% Child A/B/C 32/8/5	100% Mean CTP 11.1 ± 3.1 and PELD 19.7 ± 2.4 (1-44)	-
AFP	High in 69%	> 25 ng/mL in 91%	-	-	93999 ± 31228 ng/mL High in 87%	8000-250000 ng/dL High in 92%	Median AFP 7.3(1.2-28000) IU/L High AFP (> 100 IU/L) in 42%
Extent or stage (n or %)	-	TNM Stage III/IV in 74%	-	Advance stage in 98%	-	TNM stage I (20%), IV (80%) Advance disease in 92%	-
Vascular invasion	-	31%	42% PV 17% IVC	-	47%	54%	17%
Metastases	-	17%	29%	-	24%	0	-
Resectability	-	40%	< 10%, 18%	13%	27%	NA	NA
Outside Milan	NA	NA	NA	NA	NA	NA	NA

AFP: Alpha-fetoprotein; BA: Biliary atresia; BSEP: Bile salt export pump deficiency (PFIC2); diff: Differentiated; FLHCC: Fibrolamellar variant of HCC; GSD: Glycogen storage disease; HBV: Hepatitis-B virus; IVC: Inferior vena cava; LT: Liver transplantation; MDR3: Multidrug resistance protein3 deficiency (PFIC3); NA: Not assessed; NSPILBD: Non-syndromic paucity of bile ducts; PRETEXT: Pretreatment tumor extent evaluation; PSC: Primary sclerosing cholangitis; PV: Portal vein; TNM: Tumor node metastasis stage; Tyr: Tyrosinemia; Mod: Moderately.