Demographic, clinical and aetiological characteristics of patients with hepatocellular carcinoma followed between 2012 and 2017 at University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar.

Abstract

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. 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). 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%. 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.