Indications and Outcomes of Surgical Treatment for Hepatocellular Carcinoma: A Bicentric Study at HALD and HMO in Dakar

Abstract

Objective : To report the indications and outcomes of surgical treatment for hepatocellular carcinoma (HCC) in a series of operated patients. Patients and Methods : This was a retrospective descriptive study conducted from January 2022 to September 2023 in the General Surgery departments of Aristide Le Dantec hospital and Military Ouakam hospital. All patients who underwent hepatectomy for HCC were included. Patients who underwent tumorectomy were excluded. Diagnostic and therapeutic aspects were analyzed. Results : Thirteen out of 61 patients were included, with a sex ratio of 1.6 and a mean age of 38.7 years. Computed tomography (CT) demonstrated a wash-in and wash-out enhancement pattern in 9 cases, with a mean tumor size of 111.6 ± 36.5 mm. MRI revealed lesions evoking HCC in 4 of 7 cases. The mean AFP level was 788.9 ng/mL. Eleven patients were classified as BCLC stage A. Exploration through a Makuuchi incision (n = 11) revealed a micronodular liver in 4 cases. Eight major hepatectomies were performed, including 5 right hepatectomies. Intermittent total vascular clamping was used in 10 cases. Four morbidity events were recorded, including three biliary fistulas and one ischemic stroke. Three deaths and one recurrence were noted. Causes of death were liver failure (n = 2) and hemorrhagic shock (n = 1). Conclusion : In our setting, HCC predominantly affects middle-aged adults with a male predominance, and hepatitis B virus infection is the leading risk factor. Hepatic resection remains the cornerstone of curative treatment in our context.