Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
Hepatic resection in adolescent and young adult patients with hepatocellular carcinoma
Junji Ueda, Nobuhiko Taniai, Masato Yoshioka, Akira Matsushita, Satoshi Mizutani, Yoichi Kawano, Tetsuya Shimizu, Tomohiro Kanda, Takahiro Murokawa, Hideyuki Takata, Hiroyasu Furuki, Yuto Aoki, Mampei Kawashima, Toshiyuki Irie, Takashi Ono, Takahiro Haruna, Daigo Yoshimori, Kazuhiko Endo, Akira Hamaguchi, Hiroshi Yoshida
Junji Ueda, Akira Matsushita, Yoichi Kawano, Tetsuya Shimizu, Takahiro Murokawa, Hideyuki Takata, Takashi Ono, Daigo Yoshimori, Kazuhiko Endo, Akira Hamaguchi, Hiroshi Yoshida, Department of Gastroenterological Surgery, Nippon Medical School, Bunkyo-ku 113-8603, Tokyo, Japan
Nobuhiko Taniai, Masato Yoshioka, Satoshi Mizutani, Department of Gastrointestinal Surgery, Nippon Medical School Musashi Kosugi Hospital, Kanagawa 211-8533, Kanagawa Ken, Japan
Tomohiro Kanda, Hiroyasu Furuki, Takahiro Haruna, Department of Gastrointestinal Surgery, Nippon Medical School Tama Nagayama Hospital, Tama Shi 206-8512, Tokyo, Japan
Yuto Aoki, Mampei Kawashima, Toshiyuki Irie, Department of Surgery, Nippon Medical School Chiba Hokusoh Hospital, Inzai 270-1694, Chiba, Japan
Author contributions: Ueda J, Taniai N, Yoshioka M, Matsushita A, Mizutani S, Kawano Y, Shimizu T, Kanda T, Murokawa T, Takata H, Furuki H, Aoki Y, Kawashima M, Irie T, Ono T, Haruna T, Yoshimori D, Endo K, Hamaguchi A, and Yoshida H conceived and designed the research; Ueda J and Yoshida H drafted the manuscript and conducted the data analysis; Taniai N, Yoshioka M, Matsushita A, Mizutani S, Kawano Y, Shimizu T, Kanda T, Murokawa T, Takata H, Furuki H, Aoki Y, Kawashima M, Irie T, Ono T, Haruna T, Yoshimori D, Endo K, and Hamaguchi A revised the manuscript; all the authors have read and approved the final version to be published.
Institutional review board statement: This study was approved by the Ethics Committee of Nippon Medical School Hospital (Approval No. B-2023-795).
Informed consent statement: Given the retrospective nature of the study, consent was obtained through an optout process approved by the institutional review board.
Conflict-of-interest statement: None of the authors has any relevant financial or nonfinancial interests to disclose.
Data sharing statement:
The datasets used and analyzed during the current study are available from the corresponding author upon reasonable request to
junji0821@nms.ac.jp.
Corresponding author: Junji Ueda, MD, PhD, Associate Professor, Department of Gastro
enterological Surgery, Nippon Medical School, -5-1, Sendagi, Bunkyo-ku 113-8603, Tokyo, Japan.
junji0821@nms.ac.jp
Received: December 1, 2025
Revised: January 23, 2026
Accepted: February 24, 2026
Published online: May 24, 2026
Processing time: 171 Days and 9.5 Hours
BACKGROUND
In Japan, primary hepatocellular carcinoma (HCC) often develops in the setting of chronic hepatitis, such as persistent hepatitis B virus (HBV) or hepatitis C virus infection. Patients with HCC are commonly in their 50s or 60s, and the occurrence of HCC in individuals in their 40s or younger is extremely rare. The adolescent and young adult (AYA) population refers to individuals aged 15-39 years. Patients with cancer in the AYA population may present distinct clinical features and biological characteristics.
AIM
To evaluate the outcomes of hepatic resection for AYA patients with HCC at our institution.
METHODS
We retrospectively analyzed 885 patients who underwent hepatectomy at our institution between 1994 and 2024. Patients were categorized into two groups: the AYA group and the non-AYA group. Patient demographics, operative details, perioperative outcomes, pathological features, clinicopathological findings, overall survival (OS), and recurrence-free survival (RFS) were compared between the groups.
RESULTS
Nine patients (5 males and 4 females) were younger than 40 years. The incidence of AYA HCC was 1.0%. Six patients had a history of hepatitis B. The percentage of HBV-positive patients was significantly greater in the AYA group than in the non-AYA group, and the tumor diameter was significantly greater in the AYA group. There were no significant differences in tumor marker levels, vascular invasion, differentiation, OS rate, or RFS rate between the AYA and non-AYA groups.
CONCLUSION
The outcomes of hepatic resection for AYA patients with HCC are favorable. Early detection of AYA HCC and timely hepatectomy are recommended.
Core Tip: This study evaluated the outcomes of hepatic resection in adolescent and young adult (AYA; age 15-39 years) patients with hepatocellular carcinoma (HCC). Among 885 patients who underwent hepatectomy, 9 (1.0%) were classified as AYAs, with hepatitis B virus infection significantly more common and tumors larger in the AYA group than in the non-AYA group. However, tumor marker levels, vascular invasion, differentiation, overall survival, and recurrence-free survival did not differ between the groups. Although rare, AYA HCC showed favorable surgical outcomes, highlighting the importance of early detection and timely hepatectomy.
