Clinical Characteristics of Patients with Hepatocellular Carcinoma: A Single-Center 3-Year Experience from Somalia (original) (raw)
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World Journal of Surgical Oncology, 2022
Background: Hepatocellular carcinoma (HCC) remains a major health problem despite the emergence of several preventive and therapeutic modalities. HCC has heterogeneous and wide morpho-molecular patterns, resulting in unique clinical and prognostic criteria. Therefore, we aimed to study the clinical and pathological criteria of HCC to update the morpho-molecular classifications and provide a guide to the diagnosis of this disease. Methods: Five hundred thirty pathologically analyzed HCC cases were included in this study. The clinical and survival data of these cases were collected. Results: Hepatitis C virus is still the dominant cause of HCC in Egypt. Post-direct-acting antiviral agent HCC showed an aggressive course compared to interferon-related HCC. Old age, male gender, elevated alpha-fetoprotein level, tumor size, and background liver were important prognostic parameters. Special HCC variants have characteristic clinical, laboratory, radiological, prognostic, and survival data. Tumor-infiltrating lymphocytes rather than neutrophilrich HCC have an excellent prognosis. Conclusions: HCC is a heterogenous tumor with diverse clinical, pathological, and prognostic parameters. Incorporating the clinicopathological profile per specific subtype is essential in the treatment decision of patients with HCC. Trial registration: This was a retrospective study that included 530 HCC cases eligible for analysis. The cases were obtained from the archives of the Pathology Department, during the period between January 2010 and December 2019. Clinical and survival data were collected from the patients' medical records after approval by the institutional review board (IRB No. 246/2021) of Liver National Institute, Menoufia University. The research followed the guidelines outlined in the Declaration of Helsinki and registered on ClinicalTrials.gov (NCT05047146).
ecancermedicalscience
The aim of this study was to describe the demographic, clinical and aetiological characteristics of hepatocellular carcinoma (HCC) in a Malagasy population sample in view to defining an appropriate control program. Methods: This was a retrospective, descriptive study conducted in the Gastroenterology Department, Joseph Raseta Befelatanana University Hospital, Antananarivo, over a period of 6 years (January 2012 to December 2017). Results: A total of 42 patients were selected, 29 of whom were men (69.05%) and 13 women (30.95%) (sex ratio: 2.2). The mean age was 56.6 years with extremes of 21 and 82 years. Subjects aged 60-69 years were most affected (35.71%). Abdominal pain was the main revealing symptom (38.10%). The main aetiological factors were: hepatitis B virus (HBV) (42.86%), hepatitis C virus (19.05%) and chronic alcoholism (23.81%). All patients were cirrhotic, of which 23 patients (54.76%) had Child-Pugh B class and 15 (35.71%) Child-Pugh C. Twenty-six patients (61.90%) had α-foetoprotein level plus 500 ng/mL. Six patients (14.29%) had portal thrombosis at diagnosis. Twenty patients (47.62%) had advanced HCC (Barcelona Clinic Liver Cancer C (BCLC C)) and 21 (50%) had end-stage HCC (BCLC D). Management was palliative in 41/42 patients. The in-hospital death rate was 23.81%. Conclusion: HCC are diagnosed at advanced stage in this study. The prognosis is poor for most patients. HBV infection is the main risk factor. An effort should be made for early diagnosis and prevention.
Prognostic Indicators in Hepatocellular Carcinoma (HCC) in a Moroccan Population
HCC is the most common primary liver tumor with a high mortality rate. The prognosis for HCC on cirrhosis is generally poor and seems to be determined not only by factors linked to the tumor, but also by factors linked to cirrhosis. The main objective of our study is to determine prognostic factors in cirrhotic patients with HCC. Methods: This is a retrospective study of patients with hepatocellular carcinoma on cirrhosis liver diagnosed from January 2009 to July 2019. The diagnosis of HCC was made according to the non-invasive criteria of EASL with the use of histology for doubtful cases. Multivariate analysis was performed with a binary logistic regression model to identify prognostic factors. Results: Out of 148 patients with HCC on cirrhosis liver, the average age is 64 [18; 72] years with a predominance of female. The etiology of cirrhosis was viral B/C in 79.7%. Child's score was ≥ B7 in 35.8%. Alpha fetoprotein (AFP) exceeded >400 ng/ml in 28.3%. Invasion of the portal vein was objectified in 15.9% with the presence of metastases in 19%. Only 22.9% patients had curative treatment. Palliative means interested 77% of patients. The 1-year and 5-year survival were 68.7% and 27%, respectively. The prognostic indicators of death were respectively advanced child (p=0.005), AFP level >400 ng/ml (p=0.02) and presence of metastasis (p <0.001) Conclusion: Hepatocellular carcinoma remains a tumor Journal of Cancer Science and Clinical Therapeutics 116 with poor prognosis. The prognostic indicators of death were respectively the advanced Child, the level of AFP >400 ng/ml and the presence of metastases.
Hepatocellular Carcinoma (HCC): Epidemiology, Risk Factors, and Survival
Background: HCC is an aggressive tumour with unpredictable outcome. It is fourth most common cause of cancers in India. However, information on HCC is inadequate in India.Therefore purpose of study is to determine overall survival for patients diagnosed with hepatocellular carcinoma (HCC) and association between various predictive factors and survival. Results: The median overall survival (OS) was 5 months ranging from 0-13 months. Majority of patients were in advance stage (III/IV). All patient died by 13 months. None of the possible predictive factors were found to be significantly associated with survival (P > 0.05) by univariate analysis. However age < 59 yrs, male gender, KPS ≤ 60, AFP ≥ 400, cirrhosis, multifocality, tumour size > 10 cm, advance stage (IIIB/IV), child pugh score B/C, CLIP score ≥ 4 and raised bilirubin level had poorer survival compared to other predictive factors. Median survival was better in patient treated with TACE followed by sorafenib + palliat...
Hepatology International, 2009
Objectives 967 patients with unresectable and untransplantable, biopsy-proven hepatocellular carcinoma (HCC) were prospectively evaluated at baseline and followed up till death. Survival was the end point. Results We found that male gender, ascites, cirrhosis, portal vein thrombosis (PVT), elevated AFP or bilirubin, or alkaline phosphatase, were each statistically significant adverse prognostic factors. Patients with normal AFP survived longer than those with elevated AFP, even in the presence of PVT, large or bilobar tumors or cirrhosis. We used a bivariate analysis to separate patient sub groups based on liver function and tumor characteristics and found clear discrimination in survival between subsets; in addition both cirrhosis and presence of PVT were significant factors. We also used a purely mathematical approach to derive subgroups and a prognostic model for individual patients. Interestingly, the two approaches gave similar predictive information, which opens the possibility of a more detailed mathematical analysis in the future. The results of this large dataset show that amongst non-surgical HCC patients, there are clear subsets with longer survival. Conclusion The data supports the concept of heterogeneity of HCC. The three factors, bilirubin, AFP, and PVT predominate in prognosis.
Characteristics of Hepatocellular Carcinoma Aggressiveness Factors in Turkish Patients
Oncology, 2017
A large cohort of hepatocellular carcinoma (HCC) patients from several collaborating Turkish institutions were examined for the tumor parameters of maximum diameter (MTD), portal vein thrombosis (PVT), and α-fetoprotein (AFP) levels. A relationship was found between MTD and blood platelet levels. Patients with large ≥5 cm tumors who had normal platelet levels had significantly larger tumors, higher percent of PVT, and significantly lower blood total bilirubin and liver cirrhosis than similar ≥5 cm tumor patients having thrombocytopenia. A comparison of patients with and without PVT showed significantly larger tumors, greater multifocality, blood AFP, and C-reactive protein levels, and, interestingly, lower HDL levels in the patients with PVT. Fifty-eight percent of the total cohort had AFP levels ≤100 IU/mL (and 42.1% had values ≤20 IU/mL). These patients had significantly smaller tumors, less tumor multifocality and percent PVT, lower total bilirubin, and less cirrhosis. There was ...
Clinical Characteristics and Prognosis of Hepatocellular Carcinoma
Journal of Clinical Gastroenterology, 2000
The purpose of this study was to determine whether a relation does exist between clinicopathologic features and the prognosis of hepatocellular carcinoma (HCC) with respect to serum alpha-fetoprotein (AFP) levels at diagnosis. We reviewed the clinical data of 309 pathologically proven HCC cases divided into three groups: group 1 with normal AFP (<20 IU/mL), group 2 with moderately elevated AFP (20-399 IU/mL) and group 3 with markedly elevated AFP (Ն400 IU/mL). Of these, there were 76 (24.6%), 78 (25.2%), and 155 patients (50.2%) in groups 1, 2, and 3, respectively. We found that HCC patients with high AFP tended to have greater tumor size, bilobar involvement, massive or diffuse types, and portal vein thrombosis. Nonetheless, we could not establish a correlation between increased AFP and Okuda's stages, degree of tumor differentiation, or extrahepatic metastasis. The median survival rates in groups 1 (6 months) and 2 (7 months) were significantly longer than that of group 3 (3 months). On multivariate logistic regression analysis, positive hepatitis B surface antigen (HBsAg) status and bilobar tumor involvement represented the independent factors for predicting high AFP values. We concluded that AFP is useful not only for diagnosis, but also as a prognostic indicator in patients with HCC . However, it cannot be considered a sensitive tumor marker, particularly during the early stages in HBsAg-negative patients.
Journal of Gastroenterology and Hepatology, 2008
A total of 967 patients with unresectable and untransplantable, biopsy-proven hepatocellular carcinoma (HCC) were prospectively evaluated at baseline and followed up till death. Methods: Survival was the end-point for all analyses. Results: We found in our overall analysis, that male gender, ascites, cirrhosis, portal vein thrombosis (PVT), elevated alpha-fetoprotein (AFP) or bilirubin or alkaline phosphatases were each statistically significant adverse prognostic factors. Patients with normal AFP survived longer than those with elevated AFP, in the presence of PVT, large or bilobar tumors or cirrhosis. We used a bivariate analysis to separate patient subgroups based on poor liver function and aggressive tumor characteristics. In subgroup analysis based on these subsets, there was clear discrimination in survival between subsets; in addition both cirrhosis and presence of PVT were significant, independent but modest risk factors. The results of this large dataset show that amongst nonsurgical HCC patients, there are clear subsets with longer survival than other subsets. Conclusions: This data also supports the concept of heterogeneity of HCC.
Characteristics of Hepatocellular Carcinoma in Egyptian Patients : A Single Center Pilot Study
Afro-Egyptian Journal of Infectious and Endemic Diseases
Background and study aim: Hepatocellular Carcinoma (HCC) is regarded as one of the most widespread leading causes of mortality annually. The most frequent risk factors for HCC are chronic viral hepatitis infection, which account for 80% of all HCC cases globally. This study aims to highlight epidemiological, clinical, laboratory and radiological characteristics of HCC in patients attending Tropical Medicine Department. Patients and Methods: A Retrospective study was conducted on medical records of all patients attending Tropical Medicine Department to determine the socio demographic, laboratory, clinical and radiological characteristics of HCC. Results: 715 patients with HCC were included in this study. The mean age of HCC onset was (59.76±8.14), 68% were males, 32 % were females, 39.7 % were diabetic , Two thirds of the patients were Child-Pugh A (67%), the remaining third were child B (28.2%) and child C (4.9%). 9.5% were jaundiced, 20% were ascitic, 74.8% had splenomegaly, 8.7% had malignant PVT while 0.4 % had Benign PVT, AFP was > 400 in 16.2 % of patients. 19.8 % had received HCV treatment, 67 % were active HCV. Conclusion: Hepatocellular carcinoma is predominant in older-male patients with chronic hepatitis C not receiving treatment, and have diabetes mellitus.