Characteristics of hepatocellular carcinoma in a Saudi tertiary care center: a 10-year retrospective study

To evaluate the clinical and pathological characteristics of hepatocellular carcinoma (HCC) diagnosed at a tertiary care center in Saudi Arabia over a 10-year period.

This retrospective observational study included 44 patients diagnosed with HCC between January 2014 and December 2023. Demographic data, risk factors, tumor characteristics, and histopathological findings were extracted from medical records and pathology reports.

The cohort showed a male predominance (77.3%), with a mean age of 65.8 years. Nearly half of patients (45.5%) had negative viral hepatitis tests. Vascular invasion and portal vein thrombosis occurred in 25.0% and 22.7%, respectively. The trabecular growth pattern predominated, and many patients presented with advanced disease features and substantial tumor burden.

HCC was frequently diagnosed at an advanced stage, with a substantial proportion of viral-negative cases. These exploratory findings are consistent with an evolving epidemiologic profile of HCC in Saudi Arabia but do not establish a causal relationship between metabolic factors and HCC. Despite its retrospective single-center design and small sample size, this study provides contemporary real-world data and highlights the need for improved surveillance, earlier detection, and larger multicenter studies.