TITLE:
Causes and Stages of Hepatocellular Carcinoma at Patient Presentation at a Tertiary Medical Center in Western Saudi Arabia
AUTHORS:
Shadi Alkhayyat, Hind I. Fallatah, Hisham O. Akbar, Mahmoud S. Al Ahwal, Waleed S. Al Ghamdi
KEYWORDS:
Hepatocellular Carcinoma (HCC), Chronic Hepatitis B (CHB), Chronic Hepatitis C (CHC), Radio Frequency Ablation (RFA), Sorafenib, Saudi Arabia
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.5 No.14,
December
3,
2014
ABSTRACT: Background: With 748,300 new cases diagnosed every year,
hepatocellular carcinoma (HCC) is the 5thand the 7thmost common cancer among males
and females, respectively, and causes 7% of all cancer-related deaths. HCC
represents more than90% of primary liver cancers. Objective: The aim of the
present study was to recognize the stages of HCC at presentation in patients
who were diagnosed at King Abdul Aziz University Hospital (KAUH) and to
identify the associated laboratory features of advance HCC.Materials and Methods: A retrospective analysis of 57 HCC patients
admitted to KAUH between January 2008 and December 2012 was conducted. The
diagnosis was established using ultrasound (U/S), computed tomography (CT)
and/or magnetic resonance imaging (MRI), with or without a liver biopsy, as
well as blood testing for alpha-fetoprotein.The following data were extracted from the medical records at KAUH:
patient demographics (age, sex and nationality), laboratory results (CBC, LFT,
PT, INR and alpha-fetoprotein), radiological results, biopsy results for those
patients who underwent biopsy, outcomes (living, deceased or lost from the
follow-up), and mortality and survival rates. Results: A total of 57 HCC
patients were admitted during the study period, and 3 patients were excluded
from the analysis. Of the remaining 54 patients, 44 (81.5%) were males and 10
(18.5%) were females. The mean age was 64.54 years (SD, 11.2 years; range, 31-86 years). The majority of patients were Saudis (19, 35.2%),
non-Saudis (35, 64.8%), Egyptians (9, 16.6%) and Yemenis (7, 13%). The
remaining 19 (35.2%) patients comprised other nationalities. Chronic hepatitis
C virus was the most common cause for liver cirrhosis (35 patients, 64.8%). CT
was the primary diagnostic method (37 patients 68.5%), while 9 (16.7%) cases
were confirmed by adnominal MRI. Six patients (11.1%) were diagnosed with
abdominal ultrasound examination and elevated alpha-fetoprotein levels. In 2
(3.7%) patients, HCC was confirmed by liver biopsy. The majority of the
patients (37, 68.5%) had advanced disease. Only 21 (39%) patients underwent
radio frequency appellation (RFA). The mean survival time from diagnosis to
death was 5.9 months (SD, 5.7 months), and the longest survival time to death
was 20 months. Conclusion: The majority of our patients presented at an
advanced disease stage, and CHC was the most common underlying cause for liver
cirrhosis in our cohort of HCC patients. The proper implementation of HCC
screening programs for cirrhotic patients is expected to help detect the
treatable stages of HCC in a timely manner.