title: [Hepatocellular carcinoma. Experience at the Instituto Nacional de Cancerología].
abstract: BACKGROUND
  Hepatocellular carcinoma (HCC) is a rare tumor in Mexico. Stands in the 21st place, corresponding to 1.4% of all malignant tumors. However in Southeast Asia, Japan and Sub-Sahara Africa, its incidence is very high. Frequently this tumor is diagnosed in late clinical stages and curative surgery is difficult to perform.
  
  
  OBJECTIVE
  To analyze the general features of patients with HCC, and its management in our hospital.
  
  
  METHODS
  An observational, transversal retrospective study was performed with 63 patients with histological proved HCC.
  
  
  RESULTS
  Thirty-two were male (50.7%) and 31 female, the mean age was 56 years, 18 had history of alcohol abuse. Liver enlargement, abdominal pain and weight loss were the most common clinical manifestations. The alpha-fetoprotein (AFP) was positive in 55% of the patients, ultrasonography and computed tomography were the most useful studies. Fifty-six percent had associated chronic liver pathology, of which 51% had alcoholic cirrhosis, 43% had cirrhosis of other undetermined origin, and 6% had chronic hepatitis. Seventy percent were diagnosed in clinical stage II, 17% in stage III. Only 31% were taken to surgery, of which laparotomy and liver biopsy was performed in 70%, liver resection in 15%, liver dearterialization in 15%. Fifty-four percent of all cases did not received any kind of treatment. Postoperative complications occurred in 25% and the operative mortality was 20%, with a mean survival time of 10 months.
  
  
  CONCLUSIONS
  HCC is a rare tumor in our country. All cases were diagnosed in late clinical stages. The male-female ratio was 1:1. AFP was positive in only 55% of cases. Due to the late stages at presentation or poor clinical conditions, most tumors were considered irresectable, thereby other forms of management need to be evaluated in order to define its place. It is important to identify patients with higher risk of HCC for an early detection and management.
authors.affiliation: Departamento de Gastroenterología, Instituto Nacional de Cancerología, México, D.F.
authors.forename: R
authors.initials: R
authors.lastname: Mondragón Sánchez
authors.forename: F J
authors.initials: FJ
authors.lastname: Ochoa Carrillo
authors.forename: J M
authors.initials: JM
authors.lastname: Ruiz Molina
authors.forename: R
authors.initials: R
authors.lastname: Herrera Goepfer
authors.forename: L F
authors.initials: LF
authors.lastname: Oñate Ocaña
authors.forename: V
authors.initials: V
authors.lastname: Aiello Crocifoglio
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed