Hepatocellular carcinoma: A review of 140 cases

Saudi Arabia appears to have an usually high incidence of hepatocellular carcinoma, which has been causally associated with a high prevalence of hepatitis B virus (HBV). Other risk factors, including hepatitis C virus (HCV) infection are currently not known. A study was undertaken to establish the risk factors and clinicopathological features of hepatocellular carcinoma in Saudi Arabia. The profiles of 140 patients with a biopsy-proven hepatocellular carcinoma were analyzed. Demographic data revealed a strong male preponderance (male:female = 5.7:1) and 114 patients (81.4%) were found to have or have had HBV infection. The data concerning HCV infection were incomplete, but suggest a causal association (nine of 33 patients). An absence of alcohol as a risk factor was noteworthy. Clinical jaundice and right upper quadrant abdominal pain were the most frequent presenting features. Abnormal liver function tests were present in 125 patients 989.3%) at diagnosis and serum alpha fetoprotein was elevated in 112 patients (80%). The majority of patients had locally advanced, inoperable disease and the prognosis was uniformly dismal. The median survical was 61 days.