Clinical features of hepatocellular carcinoma in pregnancy

Objective To investigate the clinical features, treatment, and prognosis of hepatocellular carcinoma ( HCC) in pregnancy.Methods A retrospective analysis was performed for the clinical data of two patients who were diagnosed with HCC in pregnancy from January 2011 to November 2017, 23 patients with HCC in pregnancy reported in medical literature in China and foreign countries published from2010 to 2017, and 25 non-pregnant female patients of childbearing age with HCC ( control group) who were treated from January 2011 to November 2017. Results The patients' age ranged from 18 to 45 years, and most patients had a history of hepatitis B, with normal liver function or mild to moderate elevations. The most common clinical symptom was abdominal pain, and the therapies included hepatic artery embolization, interventional therapy, chemotherapy, and liver tumor resection. The 25 patients with HCC in pregnancy had poor prognosis, among whom 17 died, and among these 17 patients, 13 had available information on overall survival time, which ranged from 1 month to 2 years, with a median survival time of 2 months; 16 patients gave birth to healthy infants by cesarean section. Among the 25 non-pregnant female patients of childbearing age with HCC, 18 died, and the survival time ranged from 4 months to 6 years, with a median survival time of 1 year; 1 patient was lost to follow-up, and 6 patients were still alive before the deadline. Conclusion Most patients with HCC in pregnancy are found to have advanced HCC at the time of diagnosis. This disease has rapid progression and poor prognosis, and surgery and interventional therapy are major treatment regimens. Early identification can increase surgical rate and the opportunity for multimodality therapy.