Review of epidemiologic and clinicopathologic features of 403 hepatocellular carcinoma (HCC)‎ patients

الملخص EN

Objective : To evaluate the epidemiologic and clinicopathologic features of HCC at NCI, Cairo.

Methods : Through the NCI information network, Pathology network and review of log books of Medical Oncology Outpatient Clinics, 681 HCC patients were diagnosed And / or treated at NCI, between 1993 and 1999.

Of them 403 records were evaluated retrospectively.

Results : The frequency of HCC cases attending NCI steadily increased from 1993 up to 1997 during which relative frequency reached 3.88 % of all solid tumours.

This was followed by decrease in both number and percentage of HCC in 1998-1999.

Median age was 56.0 (18-80) years.

Male to female ratio was 2.84 : 1.

Majority of patients ( > 97 %) came from around the Nile River.

Farmers constituted 23.1% of cases.

Forty nine percent of patients were smokers and 25.7% were diabetic.

Bilharziasis was prevalent in 71.4 % and cirrhosis in 86.7 % of cases.

Twenty- one percent of cases were metastatic at first presentation, mainly intra-abdominal.

Tumour burden was greater than or equal 50 % of liver size in 67.7 % of cases, lesions were multiple in 50.5% and bilateral in 37.4 % of HCC patients.

Estrogen receptor (ER) status was positive in 14 / 50 (28 %) of HCC patients.

Serologic markers of hepatitis C virus (HCV) and/or hepatitis B virus (HBV) were positive in 93.2 % of tested patients.

Management of HCC was variable and most cases received supportive treatment (49.4 %).

Overall survival was significantly related to modality of treatment, being best with combined adriamycin with tamoxifen (median 7 months) and lowest (median one month) with non-specific therapy, p < 0.001.

Conclusion : HCC showed an increasing trend in the past few years that could be attributed to more exposure to different risk factors.

Active immunization against HCV and HBV early in childhood and population at high risk is important.

Strict environmental sanitary measures should be applied.

Screening of patients, with chronic HCV and / or HBV with or without cirrhotic liver for earlier detection of small lesions and the choice of more effective line of therapy is recommonded.