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World J Gastroenterol. Feb 7, 2007; 13(5): 781-784
Published online Feb 7, 2007. doi: 10.3748/wjg.v13.i5.781
Differences in characteristics of patients with and without known risk factors for hepatocellular carcinoma in the United States
Jon D Dorfman, Richard Schulick, Michael A Choti, Jean-Francois H Geschwind, Ihab Kamel, Michael Torbenson, Paul J Thuluvath
Jon D Dorfman, Richard Schulick, Michael A Choti, Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, United States
Jean-Francois H Geschwind, Ihab Kamel, Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, United States
Michael Torbenson, Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, United States
Paul J Thuluvath, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, United States
Author contributions: All authors contributed equally to the work.
Correspondence to: Paul J Thuluvath, MD, FRCP, The Johns Hopkins Hospital, Rm 429, 1830 E. Monument Street, Baltimore, MD 2105, United States. pjthuluv@jhmi.edu
Telephone: +1-410-6145389 Fax: +1-410-6149612
Received: September 21, 2006
Revised: October 15, 2006
Accepted: December 13, 2006
Published online: February 7, 2007
Abstract

AIM: To examine the clinical characteristics of a subgroup of patients with hepatocellular carcinoma (HCC) and compare them to those with known risk factors.

METHODS: We used the HCC database of 306 patients seen at our institution from January 1, 1995 to December 31, 2001. Of the 306 patients, 63 (20%, group 1) had no known risk factors (hepatitis C virus, hepatitis B virus, alcohol, hemochromatosis or cirrhosis from any cause) and 243 (group 2) had one or more risk factors.

RESULTS: The median age was similar in both groups, but there were disproportionate numbers of younger (< 30 years old), older (> 80 years) patients, women (33% vs 18%), and Caucasians (81% vs 52%) in group 1 as compared to group 2. There were fewer Asians (2% vs 11%) and African Americans (13% vs 27%) in group 1. Abdominal pain (70% vs 37%) was more common while gastrointestinal bleeding (0% vs 11%) and ascites (4% vs 17%) were less common in group 1 compared to group 2. Group 1 had larger tumor burden (median size 9.4 cm vs 5.7 cm) at the time of presentation, but there were no differences in the site (right, left or bilateral lesions), or number of tumors between the two groups.

CONCLUSION: HCC patients without identifiable risk factors have different characteristics and clinical presentation compared to those with known risk factors. Absence of cirrhosis and larger tumor burden may explain the differences in the presenting symptoms.

Keywords: Hepatocellular carcinoma; Patient chara-cteristics; Risk factors