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Clinical Profile and Therapy of Hepatocelluar Carcinoma at a Tertiary Care Institute from South India: A Retrospective Study of 182 Patients

Venkatesh M.* , Venkatesh M.* , Kannan T.** , Subbarao*** , Bhargavi D.**** , Ananth Pai****

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Indian Journal of Cancer Education and Research 5(1):p 29-35, January - June 2017. | DOI: DOI: http://dx.doi.org/10.21088/ijcer.2321.9815.5117.5

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Abstract

Objective: To study the clinical profile and therapy of hepatocellular carcinoma (HCC) at a tertiary care institute in Andhrapradesh, Southindia. Methods: Data analysis of HCC patients enrolled in between 2000 and 2015. HCC was diagnosed according to EASL criteria-USG/CT/MRI of the abdomen and/or serum alpha-fetoprotein and/or histology (where indicated). Barcelona Clinic Liver Cancer (BCLC) staging was done. Results: We registered 182 HCC patients [males 162 (89%), mean age 57.5 ± 12.1 years]. An “Early Peak” (17%) was detected in 28-40 yr age group. The etiology of HCC was: Hepatitis B virus 70 (35.7%), Hepatitis C virus 05 (2.74%). Serum -fetoprotein was >500 ng/ml in 43.8% and very high (>5000-100 000) in 30.6%. Classical features on triple phase CT in 80% with an average tumor size of (7.3 ± 2.1 cm), Portal vein invasion was seen in 40% and distant metastases in 11%. Majority of the patients (79.6%) were BCLC stage C and D. Biochemical: Thrombocytopenia (60%), anaemia in 30%, and 80% had an elevated alkaline phosphatase levels. Therapy was offered to 127 (69.78%) patients.Treatment given was as follows: Surgical resection (n=36 19.78%); Chemotherapy, both oral and iv (n=91 19.78%), and Sorafenib (n=36 19.78%), Best supportive care (n=55 30.22%), but survival data was not available due to lack of adequate followup. Conclusions: Hepatitis B infection is the predominant cause for HCC. Diagnostic range serum -fetoprotein was detected in only 43.8% of study patients but its level correlates well with the disease burden, outcome. An “Early Peak” was observed in 28-40 year age group. Majority of the patients present with advanced disease, precluding the curative therapies. Universal immunization with hepatitis B vaccination will reduce the HBV infection rates & in part HCC burden in near future.

Keywords: HCC (Hepatocellular Carcinoma); AFP (Alpha Fetoprotein); HBV (Hepatitis B Virus).

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DOI: DOI: http://dx.doi.org/10.21088/ijcer.2321.9815.5117.5

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