P-51 HEPATOCELLULAR CARCINOMA: ONLY EARLY DIAGNOSIS IS NOT ENOUGH

Abstract

Hepatocellular carcinoma (HCC) has an estimated prevalence of 3-5% of cases per year and is associated with high mortality. Early diagnosis can provide chance of treatment and cure. Evaluate the clinical evolution and treatment of a cohort of patients diagnosed with HCC. Retrospective study with patients from the Hepatology outpatient clinics at a university hospital with HCC, from January 2014 to December 2019. Demographic, clinical and laboratory variables were evaluated, as well as treatment indication and evolution. 77 patients with HCC and cirrhosis were included, 70% were male, aged 18 to 78 years, with a mean age of 62 years, 30% were diabetic and 25% had obesity. The main etiology of cirrhosis was hepatitis C. The average time between diagnosis of cirrhosis and evidence of HCC was 6.2 years. The size of the tumor ranged from 1.2 cm to infiltrative lesion (20%), with average of 2.9 cm. Single nodule at diagnosis was found in 60% of cases, mostly within the Milan criteria. The proposed treatment at diagnosis was liver transplant alone in 42% of cases, transarterial chemoembolization (TACE) and TACE associated with transplant in 6% and 10%, respectively, resection in 4%, Sorafenib in 15% of individuals and support treatment in 23%. However, liver transplant was performed in only half of the patients with indication, as 14% had severe comorbidities, 36% evolved with progression of the HCC and 50% refused treatment or had low adherence to follow-up. In addition to the early diagnosis of HCC, the intrinsic potential of brief tumor dissemination, the absence of serious comorbidities and the rapid intervention and therapeutic availability are essential to improve the prognosis of these patients. It is also necessary to reinforce adherence to treatment and medical follow-up.