Clinic-pathological pattern of hepatocellular carcinoma (HCC) in Egypt

Introduction: The incidence of liver cancer is one of the highest in the world. HCC represents up to 90% of all liver malignancies. In Egypt, HCC constitutes a significant public health problem. Where it is responsible for 33.63% and 13.54% of all cancers in males and females respectively. Hepatocellular carcinoma occurs in a number of preexisting conditions that commonly includes hepatitis C and B, alcoholic and nonalcoholic cirrhosis. It has a poor prognosis after discovery, which is usually at a late stage of disease. This had been strongly linked to the hepatitis C virus epidemic that affected around 10-15% of the Egyptian population during the last 3 decades, and was reported as the highest prevalence of HCV in the world. Methods: This retrospective study included 300 HCC patients. Clinical and demographic data were collected from medical records during the period between Jan 2011 till end of 2016. Results: Results revealed that 53% of the studied HCC patients were younger than 60 years old, 81.5% male and 18.5% female, 40% of the patients had an a-fetoprotein level of at least 400 ng/ml and 95.7% were positive for hepatitis viral infection, 30% of the patients had Diabetes Mellitus (DM). Majority of the patients were Child Pugh Score A and 96.7% of the cases were diagnosed without tissue biopsy. About 36%of the cases presented with stage IV and 34.8% of the cases had lymph node involvement &vascular invasion radiological. Sorafenib was received by 30% patients as first line or after progression from local therapy. Conclusion: HCC in Egypt occurred in men who developed a cirrhotic liver due to HCV infection. Epidemiological and histopathological data of HCC highlight the importance of an integrated strategy for the prevention and the treatment of viral hepatitis infections and chronic liver disease. Tissue biopsy is not required to make the diagnosis of HCC. There were well-defined tumor markers & imaging criteria for that. Many patients presented with advanced disease beyond curative surgery.