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Clinical and Epidemiological Characteristics of Hepatocellular Carcinoma Analysis of a Tertiary Referral Center in Brazil
In Brazil, hepatocellular carcinoma (HCC) is the sixth leading cause of cancer-related deaths and the incidence is increasing worldwide. Several modifiable and non-modifiable HCC risk factors have been described. However, clinical and epidemiological aspects of HCC are still underreported in Brazil.
To investigate the main characteristics of patients with HCC at one Brazilian tertiary care center.
Retrospective analysis of patients diagnosed with HCC in the last 3 years. Epidemiological, clinical, tumor characteristics, staging and type of treatment were reviewed.
70 patients were included. There was a predominance in males (78%) and mean age was 65,6 (± 12,2) years. 60 (90%) patients were cirrhotic. Etiologies of liver cirrhosis were: alcohol abuse (31%), hepatitis C infection (22%), followed by cryptogenic (17%), nonalcoholic fatty liver disease (14%) and hepatitis B infection (11%). 38 (54%) cirrhotic patients were Child-Pugh A, 42 (60%) harbored a single tumor at diagnosis and 37 (52%) had normal alpha-fetoprotein. 38 (51%) were classified as Barcelona Clinic Liver Cancer (BCLC) stage 0 or A, 12 BCLC B (17%) and 22 BCLC C or D (31%). 34 (48%) patients were diagnosed at a non-curative stage. Chemoembolization and radiofrequency ablation were the main procedures performed in 20 (28%) and 15 (21%), respectively. 10 (14%) were transplanted. The mortality during the period analyzed was 27%.
Alcohol abuse and hepatitis C infection were the leading causes of chronic liver disease associated with HCC. Approximately 50% of patients were classified as very early or early stage, which are potentially curable. These results highlight the need to increase early diagnosis and policies focused on changing risk factors for better outcomes.
Hepatocellular carcinoma; Liver nodules; Liver cirrhosis;
Gastroenterologia - Fígado
MARTIN KENICHI YUAMI, Carolina Rodrigues Dias Carmo, Lívia Quintanilha Santos, Camila Guimarães Ribeiro de Moraes, Luana Antunes Silqueira Neves, Bruna Pereira Franca