Hepatocellular carcinoma. A 5 year institutional experience

Area of Science:

• Hepatology
• Oncology
• Medical Diagnostics

Background:

• Liver cancer, particularly hepatocellular carcinoma (HCC), is a global health concern with underappreciated significance in North America.
• HCC incidence is rising, often linked to chronic liver inflammation, necessitating a closer examination of its prevalence and characteristics in specific regions.

Purpose of the Study:

• To analyze the clinical characteristics, diagnostic methods, and outcomes of adult patients diagnosed with hepatocellular carcinoma at an institution in the Pacific Northwest.
• To highlight the challenges in early diagnosis and the poor prognosis associated with HCC in this region.

Main Methods:

• Retrospective review of 35 adult patients diagnosed with hepatocellular carcinoma over a 5-year period.
• Analysis of patient demographics, presence of pre-existing liver inflammation, presenting symptoms, diagnostic modalities (alpha-fetoprotein, liver scan, CT scan), associated malignancies, and survival data.

Main Results:

• Hepatocellular carcinoma was diagnosed in 35 adult patients, with 77% having pre-existing liver inflammation.
• A significant proportion of patients were asymptomatic or presented with non-specific symptoms; 29% were asymptomatic at diagnosis.
• Diagnostic tools like alpha-fetoprotein, liver scan, and CT scan were utilized.
• The mean survival was poor at 5 months, with only two patients surviving over 1 year.
• Eight patients (23%) had other associated malignancies.

Conclusions:

• Hepatocellular carcinoma, while uncommon, is a significant malignancy in the Pacific Northwest, frequently arising from chronic liver inflammation.
• Late diagnosis and a grim prognosis are characteristic of HCC in this population.
• Prevention of chronic liver inflammation and mass screening of high-risk populations are essential strategies to reduce HCC-related mortality.