Hepatocellular carcinoma during pregnancy: Is hepatocellular carcinoma more aggressive in pregnant patients?

Background/purpose: Hepatocellular carcinoma (HCC) during pregnancy is a very rare condition and is believed to have a worse prognosis than HCC in non-pregnant women. We evaluated the prognosis and the diagnostic and therapeutic strategies for HCC in pregnant women. Methods: We retrospectively analyzed 4 cases in our hospital and 44 cases described in the medical literature since 1957; we also compared the cases reported before 1995 and those reported during/after 1995. Results: The overall 6-month and 1-, 2-, and 3-year survival rates in the patients reported in the literature were 50, 29.5, 18.2, and 13.6%, respectively (n = 44). The mean ages at diagnosis before and during/after 1995 were 31.4 ± 7.2 and 28.9 ± 4.4 years, respectively (P = 0.113). The following characteristics were significantly more common in the later group: fewer pregnancies; the absence of advanced signs or symptoms; receipt of therapy; tendency to undergo surgery; and higher 6-month and 1-, 2-, and 3-year survival rates. The median survivals of the groups before and during/after 1995 were 18 and 25.5 months, respectively (P < 0.001). Conclusions: The morbidity and mortality of HCC during pregnancy has improved over time, as diagnoses have tended to be made earlier and patients have tended to receive surgical and other treatments.