Hepatocellular carcinoma

Objective: To describe the etiology, clinicopathological features and outcome of hepatocellular carcinoma (HCC). Design: A retrospective study. Place and Duration of Study: The study was conducted at The Aga Khan University Hospital, Karachi, on patients admitted between January 1994 and December 1998. Subjects and Methods: A total of 201 consecutive patients diagnosed to have primary HCC on liver biopsy were the subjects of this study. Data included clinical and physical examination, routine hematological and bio-chemical investigations along with alpha-fetoprotein (α-FP or AFP) and imaging studies. Results: The mean age at the time of diagnosis was 56 years (24 to 85 years). There was a male preponderance (74%). The mean α-FP was 17,027 ± 68,853 ng/ml. The viral hepatitis profile was: HBsAg positive = 36%; Anti-HCV positive = 41%; both positive = 7%; both negative = 16%. HBV-related HCC patients were found to be younger than HCV-related HCC patients (49.7 v/s 56.3 years; p = NS). However, there was no significant difference in the survival rates of either group of patients. The median survival time was 16 weeks. Conclusion: HBV and HCV account for 84% of HCC in Pakistan. Majority of the patients had advanced stage of HCC. The median survival was 16 weeks.