Author(s): Kumar R, Saraswat MK, Sharma BC, Sakhuja P, Sarin SK
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Abstract BACKGROUND: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide. The outcome of the disease is related to the stage of presentation. A comprehensive analysis of patients with this disease is not available in India. METHODS: Retrospective chart review of 246 patients with HCC was done. One hundred ninety-one patients (male 160, female 31; median age 52 years, range 9-85 years) fulfilling diagnostic criteria for HCC adopted by Barcelona-2000 EASL conference were analyzed for clinical, etiological, radiological and cytohistological profile. RESULTS: Underlying cirrhosis was seen in 60\% cases with hepatitis B being the most common etiologic agent. HCC caused new onset ascites and recent worsening in three-fourth cases with ascites. Paraneoplastic syndrome was a rare event in HCC in India. Diagnostic level of serum AFP was seen in only 46\% with significant difference between cirrhosis HCC patients compared with non-cirrhosis HCC patients (53\% vs. 26\%; P = 0.046). Most cases (83\%) presented at advanced stage (Okuda III or IV) and cytohistology was the best method to diagnose HCC. Vascular invasion was seen in half the patients (53\%) by the time they presented with extrahepatic spread of tumor in 13\% cases. CONCLUSION: The prevalence of advanced stage HCC makes most of the detectable lesions unsuitable for curative resection. However, universal hepatitis B vaccination program may become the most effective preventive measure to control this disease in India.
This article was published in QJM
and referenced in Journal of Patient Care