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News

Epidemiology of primary hepatic malignancies in US children

Hepatocellular carcinoma has poorer survival rates than hepatoblastoma, but its incidence has not increased in recent decades, report scientists in the September issue of Hepatology.

News image

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The epidemiology of primary hepatic malignancies in children in the United States is not clear.

In this study, a team of scientists from analyzed the incidence, mortality, and characteristics of these malignancies.

The team identified fatal primary hepatic malignancies in persons under 20 years of age, occurring between 1979 and 1996.
Rates were higher among both Asians and foreign-born children.
Hepatology

In addition, they identified histologically confirmed primary hepatic malignancies, occurring between 1973 and 1997, using the Surveillance, Epidemiology, and End Results (SEER) database.

The researchers found that, between 1979 and 1996, 918 primary hepatic malignancy deaths were reported nationally in persons under 20 years of age. This was an average of 0.7 per 1,000,000 per year.

The team determined that the rates were higher among both Asians and foreign-born children.

Furthermore, they found that, between 1973 and 1997, 271 primary hepatic malignancy cases in individuals younger than 20 years were reported to SEER. Of these 67% were hepatoblastoma and 31% were hepatocellular carcinoma.

In children under 5, hepatoblastoma accounted for 91% of primary hepatic malignancy cases. However, in patients aged 15 to 19 years of age, hepatocellular carcinoma accounted for 87% of cases.

The team calculated that the 5-year survival for hepatoblastoma was 52%, compared with 18% for hepatocellular carcinoma.

Using the SEER data, the team found that, between 1973 and 1977, and 1993 and 1997, hepatoblastoma rates increased from 0.6 to 1.2 per 1,000,000. However, this same data showed a drop in the rate of hepatocellular carcinoma rates from 0.45 to 0.29 per 1,000,000.

Dr Anil Darbari's team concluded, "Histologically confirmed hepatocellular carcinoma was reported in children less than 5 years of age, also, where hepatoblastoma is the predominant primary hepatic malignancy".

"Hepatocellular carcinoma has worse survival rates than hepatoblastoma, and its incidence has not increased".

"Better maintenance of databases may provide information about associated factors behind this unexpected occurrence".

Hepatology 2003; 38: 560-6
28 August 2003

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