Publication:

Trends of etiology and treatment in hepatocellular carcinoma over the years

Background HCC has been the fastest-growing cause of cancer-related deaths. The aim of this study was to investigate the change trends in the etiology, treatment and mortality of HCC over the last 12 years.

Methods The study included 523 patients who were admitted to our clinic with the diagnosis of primary malignancy of the liver between 2006-2018. Demographic data, HCC etiologies, alpha feto-protein (AFP) values and imaging characteristics were recorded. The patients were divided into two groups as diagnosed before 2013 and 2013 and later. Because the number of patients with alcohol and HBV was high, it was evaluated as a separate etiology group. HCC was accepted related to NASH in the patients with obesity and diabetes mellitus (DM) after exclusion of HBV, HCV, and autoimmune hepatitis. The patients without obesity and DM were accepted as cryptogenic HCC and added to other etiologies group.

Results When the patients were evaluated, there was a significant increase in the rate of patients who were in compensated cirrhosis stage and in UCSF criteria in and 2013 and later (p = 0.0001, p = 0.037, respectively). A significant increase was observed in the ratio of NASH-related HCC 2013 and later (p = 0.032). Transplantation, resection and RFA / PEI rates were 14.9% before 2013 and 22.2% 2013 and later (p = 0.047).

Conclusions The rates of NAFLD related HCC due to diabetes and obesity are increasing. Knowing the change of HCC causes over the years is necessary for the effective treatment for these reasons in the future.