Therapeutic Effect of Transcatheter Arterial Chemoembolization in Young Patients with Unresectable Hepatocellular Carcinoma

Hepatocellular carcinoma is one of the most common malignant tumors in the world. The peak age of onset of hepatocellular carcinoma varies according to geographic barriers. Different hepatocarcinogenesis were found among population of young and elder age and, therefore, the prognosis might be different among them. The aim of this study is to evaluate the therapeutic efficacy of transcatheter arterial chemoembolization in young patients with unresectable hepatocellular carcinoma. From 1983 to 1998, 42 patients younger than 40 years old with unresectable hepatocellular carcinoma underwent transcatheter arterial chemoembolization. Three patient had oligonodular type hepatocellular carcinoma, 8 had multiple nodular, 21 had massive solitary (14 of them had multiple daughter nodules) and 10 had infiltrative hepatocellular carcinoma. Transcatheter arterial chemoembolization was performed by transcatheter hepatic arterial infusion of adriamycin-lipiodol emulsion followed by delivery of gelatin sponge particles. We retrospectively review the clinical manifestations, tumor features and therapeutic efficacy of transcatheter arterial chemoembolization in young patients. In addition, 113 patients with hepatocellular cacinoma with their age ranged from 61 to 69 years old, and underwent transcatheter arterial chemoembolization during the same period were also reviewed for comparison. The overall survival rates at 6, 12, 24 and 36 months periods were 70.01, 47.27, 23.76 and 7.92% for patients younger than 40 years old (median survival was 15 months) vs 77.88, 65.89, 49.27 and 29.04% for patients aged 61 to 69 years old (median survival was 25 months). Transcatheter arterial chemoembolization does not show as good survival benefit in young patient group as elderly patient group.