Facebook
Twitter
LinkedIn
Email
 |
Checking for direct PDF access through Ovid | |
Excerpt
Introduction. Unlike hepatocellular carcinoma (HCC) in US adults, there is little comparable information regarding hepatic malignancies in US children. The purpose of this report was to analyze the incidence, mortality, and possible etiologic factors associated with primary and secondary hepatic malignancies in US subjects under 20 years of age during 1973-1996.
Methods. The Surveillance, Epidemiology and End Result (SEER) database of the National Cancer Institute, representing 14% of the US population, was utilized to analyze incidence and mortality from 1973-1996. From the National Center for Health Statistics (NCHS) database multiple cause death certificates listing "liver cancer" as a cause of death between 1979-1995 were analyzed for mortality and possible etiologic factors. Normative data was obtained from the 1990 US census.
Results. Liver tumors constituted 0.1% of all childhood tumors. 88% of the liver tumors were primary. Under 4 years, secondary tumors included neuroblastoma, ganglioneuroblastoma, and sympathetic tumors, while soft tissue and embryonal sarcomas predominated in older children. The SEER database representing 14% of US population had 63 histologically confirmed HCC cases, making an estimated 20 children per year in the US population. The incidence increased with age to peak at 10-14 years. 777 children died of primary liver tumors between 1975-1995, with the mean age of 8.2 years. The highest incidence was observed in 0 - 4 years-olds; of these, 93% were hepatoblastoma (HB). The overall male:female (M:F) ratio was>1 for both HCC (1.2:1) and HB (1.9:1), but the incidence of HCC in 15-19 year-olds was slightly higher in females. In the NCHS data, death rate was 43/yr and M:F ratio was 1.32:1, probably reflecting the HB rates in the database. 77% of all children with primary liver tumors were white compared to 72% in US population. Over the study period, childhood HCC decreased, whereas all childhood tumors and HCC in adults increased. Hepatitis B (12/777) was most commonly associated, but most cases did not mention etiology or underlying cirrhosis.
Conclusions. Primary liver tumors in US children are not as rare as was previously understood. Our data suggest that aggressive preventive and treatment strategies for childhood HCC are needed.
