Epidemiologic and Clinicopathologic Features of Advanced Hepatocellular Carcinoma
- 1 Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
Abstract
Background : Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide as well as in Egypt where it constitutes a significant public health problem. HCC is the third most common cause of death from cancer and chronic infection with HBV and HCV are the most important precursors for HCC development. Objective: To study the epidemiologic, clinical and pathological features of advanced HCC in clinical oncology and Nuclear medicine department, Suez Canal University hospital. Method: This is a retrospective study done to analyse the clinical, demographic and pathological data of advanced HCC patients that attended clinical oncology and Nuclear Medicine Department, Suez Canal University Hospital in the period between January 2013 and December 2016. Results: Results revealed that mean age of the patients was 60.2 ± 7.69, 71.74% male and 28.26% Female, 91.3% were HCV positive while 6.5% were HBV positive. Liver cirrhosis was in 89.13% of patients. Majority of the patients (78.2%) were child Pugh Score B and 21.7% were child Pugh Score C. 67.39% of patients had diabetes. Portal vein thrombosis was present in 50% of cases. Alpha fetoprotein was elevated >400 in 56.52% of cases. Thirty four patients received treatment in the form of chemotherapy while 12 patients did not receive treatment. There is a highly significant increase in survival time P < 0.001 in treated group compared to untreated group. Median survival time (in months) was five months in the treated group versus one month in the untreated group. Conclusion: HCC is one of the increasing major health problem s in both developing and developed countries. The most important risk factor is cirrhosis which i s mainly due to HCV infection. Thus, much effort should be put into the field of prevention and treatment of viral hepatitis infections and chronic liver disease. Screening programs should be done to get rid of the problem, and most importantly, there must be an acceptable and effective therapy for HCC.
- Poustchi, H., Sepanlou, S., Esmaili, S., Mehrabi, N. and Ansarymoghadam, A. (2010) Hepatocellular Carcinoma in the World and the Middle East. Middle East Journal of Digestive Diseases, 2, 31-41.
- Ferlay, J., Shin, H.R., Bray, F., et al. (2010) Cancer Incidence and Mortality Worldwide: IARC Cancer Base No. 10. IARC Press, Lyon, France. http://globocan.iarc.fr.
- Ahmad, J. and Rabinovitz, M. (2005) Etiology and Epidemiology of Hepatocellular Carcinoma. In: Carr, B.I., Ed., Current Clinical Oncology, Humana Press Inc., Totowa, 1-22. https://doi.org/10.1007/978-1-59259-844-1_1
- Bosch, F.X., Ribes, J. and Borras, J. (1999) Epidemiology of Primary Liver Cancer. Seminars in Liver Disease, 19, 271-285. https://doi.org/10.1055/s-2007-1007117
- El-Zayadi, A.R., Abaza, H., Shwaky, S., et al. (2001) Prevalence and Epidemiological Features of Hepatocellular Carcinoma in Egypt—A Single Centre Experience. Hepatology Research, 19, 170-179. https://doi.org/10.1016/S1386-6346(00)00105-4
- Llovet, J.M., Ricci, S., Mazzaferro, V., et al. (2008) Sorafenib in Advanced Hepatocellular Carcinoma. The New England Journal of Medicine, 359, 378-390. https://doi.org/10.1056/NEJMoa0708857
- Llovet, J.M., Bustamante, J., Castells, A., et al. (1999) Natural History of Untreated Nonsurgical Hepatocellular Carcinoma: Rationale for the Design and Evaluation of Therapeutic Trials. Hepatology, 29, 62-67. https://doi.org/10.1002/hep.510290145
- Pande, S.B., Doval, D.C., Pavithran, K., et al. (2012) Gemcitabine and Cisplatin-Based Combination Chemotherapy in Advanced Hepatocellular Carcinoma: An Indian Experience. Indian Journal of Medical and Paediatric Oncology, 33, 42-47. https://doi.org/10.4103/0971-5851.96968
- Kumar, R., Saraswat, M.K., Sharma, B.C., et al. (2008) Characteristics of Hepatocellular Carcinoma in India. A Retrospective Analysis of 191 Cases. QJM: An International Journal of Medicine, 101, 479-485. https://doi.org/10.1093/qjmed/hcn033
- Gomaa, A.I., Khan, S.A., Toledano, M.B., et al. (2008) Hepatocellular Carcinoma Epidemiology, Risk Factors and Pathogenesis. World Journal of Gastroenterology, 14, 4300-4308. https://doi.org/10.3748/wjg.14.4300
- Anwar, W.A., Khaled, H.M., Amra, H.A., et al. (2008) Changing Pattern of Hepatocellular Carcinoma (HCC) and Its Risk Factors in Egypt: Possibilities for Prevention. Mutation Research/Reviews in Mutation Research, 659, 176-84. https://doi.org/10.1016/j.mrrev.2008.01.005