Publication:

Study on the clinical and etiological profile of hepatocellular carcinoma in a tertiary care centre in south India: a prospective observational study

Background Hepatocellular carcinoma (HCC) is the most common primary malignant tumour of the liver occurring in patients with underlying chronic liver disease with high morbidity and mortality with various clinical presentations. This study was conducted to analyse the clinical and etiological profiles of HCC patients in tertiary care liver transplant centre.

Methods This prospective cross-sectional study was conducted in the department of medical gastroenterology, government Stanley medical college, for one year, with a sample size of 75 patients. Clinical details, demography, laboratory parameters and imaging findings are entered in pre-structured proforma.

Results Among 75 patients, 69 were males (92%). The mean age of patients was 45.5±10 years. Abdominal pain in 56 (80%) and abdominal distension in 31 patients (44.2%%) was the most common symptom, with underlying cirrhosis in a majority (70.6%). The etiologies include hepatitis B in 25 (33.3%), ethanol in 20 (26.6%), hepatitis C in 8 (10.6%), NAFLD in 8 (10.6%) and cryptogenic in 11 (14.6%) patients. AFP levels >400 ng/ml were observed in 37 cases (49.3%) with a mean value of 6129 ng/ml with normal in 12 (16%) cases. On imaging, multifocal lesions were seen in 24(32%) patients and vascular invasion in 30 (40%) patients. Most of the patients belong to BCLC stage C (54.6%), followed by stage B (30.6%) and stage A (12%) and two patients (2.6%) in stage D. Patients were managed according to institutional protocol with either hepatectomy, TACE, systemic chemotherapy or combination of these modalities.

Conclusions In our study, HBV (33%) and alcohol (27%) were the most common etiologies, with the majority having underlying cirrhosis.