Hepatocellular carcinoma in the Rhodesian African

Area of Science:

• Hepatology
• Medical Oncology
• Epidemiology

Background:

• Hepatocellular carcinoma (HCC) is a prevalent malignancy in specific populations.
• Previous studies suggested a correlation between HCC and younger demographics lacking chronic liver disease in high-incidence areas.
• Understanding the epidemiological and clinical characteristics of HCC in diverse populations is crucial for diagnosis and management.

Purpose of the Study:

• To prospectively survey primary liver carcinomas in Rhodesian Black adults over one year.
• To investigate the clinical presentation, diagnostic markers, and etiological associations of HCC in this cohort.
• To compare findings with existing literature on HCC epidemiology.

Main Methods:

• Prospective survey of 28 primary liver carcinoma cases over one year.
• Clinical data collection including patient demographics, presenting symptoms, physical examination findings, and diagnostic test results.
• Analysis of alpha-feto protein levels, Hepatitis B antigen status, liver function tests, and correlation with alcohol consumption and cirrhosis.

Main Results:

• Hepatocellular carcinoma was the most common liver malignancy, with a high pre-mortem diagnosis rate (96.4%).
• Age distribution was wide, with many patients showing signs of chronic liver disease, contradicting some prior assumptions.
• Common symptoms included abdominal pain, swelling, and weight loss; hepatomegaly was nearly universal.
• Alpha-feto protein levels were relatively low (46.5%), and Hepatitis B antigen was absent in all cases.
• High alcohol consumption and cirrhosis were confirmed as associated factors.

Conclusions:

• Hepatocellular carcinoma in Rhodesian Black adults presents across a broad age range, often with established liver disease.
• The low incidence of alpha-feto protein and absence of Hepatitis B antigen suggest different etiological pathways or diagnostic marker utility in this population.
• Alcohol consumption and cirrhosis remain significant risk factors for hepatocellular carcinoma in this region.