Abstract
BackgroundThe prevalence of hepatocellular carcinoma (HCC) is increasing worldwide and it is now the third most common cause of cancer-related death. HCC is becoming a major health burden with steadily increasing incidence globally.MethodsThis is an observational study over a 3-year period in a tertiary care center in India. Three hundred and thirty-nine patients diagnosed to have HCC were included in this study. Patients’ clinical, etiological, radiological and cytohistological data and therapy offered were recorded and analyzed.ResultsCirrhosis of the liver was seen in 73.2% of the patients. 16.8% of patients were asymptomatic at the time of presentation. Ascites (57.2%) and jaundice (22.4%) were the most common signs of hepatic decompensation. The most common etiology of HCC was cryptogenic/non-alcoholic fatty liver disease (NAFLD) in 51% of the patients, while hepatitis B and C were seen in 17.4% and 5.8% of the patients, respectively. Advanced and end-stage disease with Barcelona Clinic Liver Cancer (BCLC) stages C and D were seen in 62.4% of patients. 56.6% had Albumin-bilirubin (ALBI) score of 2, while 62.8% had Okuda stage II disease. High alpha-fetoprotein (AFP) levels (>400 ng/mL) were seen in 48.9% of patients. Macrovascular invasion and metastases were seen in 45.9% and 22.2% of the patients, respectively. 17.6% of patients had evidence of tumor thrombus. 14.5% of biopsy specimens showed associated steatosis/steatohepatitis along with confirmation of HCC. Only 26.6% of the cirrhotic HCC patients were diagnosed during surveillance.ConclusionsHCC due to unknown cause/NAFLD appears to be overtaking hepatitis B as the commonest cause for HCC. Despite the advances in diagnostic methods and surveillance, most cases of HCC tend to be diagnosed at advanced stages.
Highlights
The incidence and prevalence of hepatocellular carcinoma (HCC) is rising, mainly due to the epidemic of non-alcoholic fatty liver disease (NAFLD), and is poised to become the leading cause of liver cancer [1]
All the patients who fulfilled the diagnostic criteria of HCC according to European Association for the Study of the Liver (EASL) guidelines were taken into study [6]
Majority (91.1%) of the patients were male. 73.2% (248/339) of the patients with HCC had a background of cirrhosis on imaging at the time of diagnosis, while the remaining 26.8% (n=91) of HCC patients were non-cirrhotic
Summary
The incidence and prevalence of hepatocellular carcinoma (HCC) is rising, mainly due to the epidemic of non-alcoholic fatty liver disease (NAFLD), and is poised to become the leading cause of liver cancer [1]. The incidence of HCC in cirrhotics in India was observed to be 1.6% per year [5]. With this background, we conducted this retrospective study to know the clinical, etiological, radiological, and histological profile of patients with HCC. The prevalence of hepatocellular carcinoma (HCC) is increasing worldwide and it is the third most common cause of cancer-related death. HCC is becoming a major health burden with steadily increasing incidence globally
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