Occurrence and clinical characteristics of hepatocellular carcinoma in the north-eastern Poland

Hepatocellular carcinoma (HCC) is the fifth most common malignancy and the third leading cause of cancerrelated mortality worldwide. Risk factors for this malignancy include liver cirrhosis, HBV or HCV infection, fatty liver disease.

This study aims to assess the occurrence and clinical characteristics of HCC in the Northeastern Poland between 2011 and 2015. The number of primary lesions, their size and location within the liver were analysed. The risk factors for this cancer in studied population have been identified. The usefulness of AFP screening and imaging studies for the diagnosis of HCC were assessed. A preliminary analysis of the efficacy of anti-tumour therapy was performed.

Sixty-seven patients (28% female and 72% male) with diagnosed HCC were enrolled. HCC diagnosis was established according to the criteria proposed by the International Consensus Group for Hepatocellular Neoplasia. Of the 67 patients in the study, 7 (10%) were aged 30 to 50 years and 60 patients (90%) were aged 51 years and older. During the period 2011-2015, an increase in HCC incidence was observed. In studied group the most prevalent (31%) were patients with 2 tumours localised in the 6th, 7th or 8th segments of the liver. Metastatic tumours were present in 15% and portal vein thrombosis in 9% of patients. Risk factors assessment revealed that in 72% of patients HCC coexisted with cirrhosis, 33% of patients were HCV-infected, 30% had HBV infection, and 15% were diagnosed with NASH. Elevated serum AFP level was observed in 83% of patients with liver cirrhosis, and in 58% of patients without cirrhosis (p <0.05). Liver transplantation was the best therapeutic option. The efficacy of ablation/resection in combination with sorafenib vs. ablation/partial resection was comparable.

There has been an increase in the number of HCC cases in North-eastern Poland in last few years. HCC is more common in men aged 50 years and older. Increased serum AFP level is a useful marker for the diagnosis and monitoring of HCC treatment in patients with liver cirrhosis.