Clinical Characteristics of Primary Liver Cancer Patients Presenting to Mayo Hospital, Lahore

Abstract

Objective: To determine the clinical characteristics of patients with hepatocellular carcinoma
and common risk factors associated with development of this disease.
Methods: In this cross-sectional study clinical data of 151 HCC patients was collected over one
year Jan 2017-Dec 2017. Variables included age, sex, socioeconomic status, presence or
absence of liver cirrhosis, tumor size, tumor stage, presence of portal vein thrombosis, hepatitis
serology, serum AFP levels, and management received. SPSS 22 was used for statistical
analysis. Mean and standard deviation was calculated for quantitative variables like age and size
of tumor and frequency and percentage was calculated for qualitative variables like gender,
socioeconomic status etc.
Results: Total 151 patients were included in the study. 106(70%) were males. Mean age of
presentation was 57.1 ± 8.6 years. Patients with rural background were 115 (76.2%) and urban
cases were 36 (23.7%). 136 (90%) patients belonged to lower socioeconomic strata while 15
(10%) were of middle social class. Most common cause found was viral hepatitis, with 104 (69%)
patients were positive for Hepatitis C virus, 27 (18%) were positive for Hepatitis B virus, 6 (4%)
were infected with both. Serum Alpha fetoprotein was raised more than 400 ng/ml in in 67 (44 %).
Mean tumor size was 8.2 cm ± 2.9 cm. 32%, 47%, and 21% patients had Child class A, B and C
respectively at the time of presentation. A total of 93(61.6%) received 5FU therapy, 7(4.7%)
underwent surgery, 18(11.9%) received sorafenib therapy and only 1 patient (0.6%) opted for liver
transplant.
Conclusions: Hepatitis C virus has been found the most prevalent cause for nurturing HCC in
this study, and most of the patients present at advanced stages, with large tumor size and portal
vein thrombosis, where only palliative therapies can be offered. There is a need to devise and
implement an effective screening programs for prevention, early detection and treatment of viral
hepatitis. In patients who have developed cirrhosis already, should be kept on close follow up so
that early and curative intervention can be offered to save precious lives.