Comparison of childhood hepatic malignancies in a hepatitis B hyper-endemic area

Table 1 Points scored for clinical and laboratory parameters in Pugh modification of Child’s classification of liver disease severity

Clinical and laboratory parameters	Points scored
	1	2	3
Hepatic encephalopathy1	None	Grade 1 or 2	Grade 3 or 4
Ascites	Absent	Slight	Moderate
Bilirubin (mg/dL)	< 2	2-3	> 3
Albumin (g/dL)	> 3.5	2.8-3.5	< 2.8
Prothrombin time prolongation (s)	1-4	4-10	> 10

¹Grade 0: normal consciousness, personality, neurological examination; Grade 1: restless, sleep disturbed, irritable/agitated, tremor, impaired hand writing; Grade 2: lethargic, time-disoriented, inappropriate, asterixis, ataxia; Grade 3: somnolent, stuporous, place-disoriented, hyperactive reflexes, rigidity; Grade 4: unrousable coma, no personality/behavior, decerebrate.

Table 2 Summary of clinical characteristics, laboratory investigations, cirrhosis, primary resectability, chemotherapeutic conversion and tumor recurrence in children with hepatic malignancies

	Hepatocellular carcinoma	Hepatoblastoma	P
Mean age in yr (SD)	10.6 (3.3)	2.5 (3.5)	< 0.0012
Median age in yr	11.3	1
Sex			0.42
Male	56	38
Female	17	16
Serum alpha fetoprotein			0.2991
≤20 ng/mL	1	3
>20 ng/mL	54	34
Hepatitis B carrier			< 0.001
Yes	56	4
No	0	31
Child’s classification			0.673
A	41	29
B	14	8
Liver cirrhosis			< 0.001
Yes	26	0
No	14	30
Primary complete resection			0.285
Yes	12	13
No	61	41
Tumor recurrence after resection			0.0411
Yes	7	2
No	5	11
Complete resection after chemotherapy			< 0.001
Yes	0	12
No	14	6

¹Fisher’s exact test and

²Two samples, independent-groups t test.

Table 3 Summary of tumor extent and invasiveness on imaging studies of children with hepatic malignancies

	Hepatocellular carcinoma (%)	Hepatoblastoma (%)	P
Bilobar involvement	38/56 (67.9)	20/38(52.6)	0.136
Portal vein invasion	22/56 (39.3)	5/38 (13.2)	0.006
Inferior vena cava invasion	8/56 (14.3)	3/38 (7.9)	0.5161
Para-aortic lymphadenopathy	10/56 (17.9)	1/38 (2.6)	0.0261
Hepatic hilum involvement	3/56 (5.4)	2/38 (5.3)	1.0001
Distant metastasis at diagnosis	19/73 (26.0)	11/54 (20.4)	0.458

¹Fisher’s exact test.