Characteristics of hepatocellular carcinoma in India: a retrospective analysis of 191 cases.
BACKGROUND
Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide. The outcome of the disease is related to the stage of presentation. A comprehensive analysis of patients with this disease is not available in India.


METHODS
Retrospective chart review of 246 patients with HCC was done. One hundred ninety-one patients (male 160, female 31; median age 52 years, range 9-85 years) fulfilling diagnostic criteria for HCC adopted by Barcelona-2000 EASL conference were analyzed for clinical, etiological, radiological and cytohistological profile.


RESULTS
Underlying cirrhosis was seen in 60% cases with hepatitis B being the most common etiologic agent. HCC caused new onset ascites and recent worsening in three-fourth cases with ascites. Paraneoplastic syndrome was a rare event in HCC in India. Diagnostic level of serum AFP was seen in only 46% with significant difference between cirrhosis HCC patients compared with non-cirrhosis HCC patients (53% vs. 26%; P = 0.046). Most cases (83%) presented at advanced stage (Okuda III or IV) and cytohistology was the best method to diagnose HCC. Vascular invasion was seen in half the patients (53%) by the time they presented with extrahepatic spread of tumor in 13% cases.


CONCLUSIONS
The prevalence of advanced stage HCC makes most of the detectable lesions unsuitable for curative resection. However, universal hepatitis B vaccination program may become the most effective preventive measure to control this disease in India.
Kumar
R
R
Department of Hepatology, Institute of Liver and Biliary Sciences, G.B. Pant Hospital, Delhi, India.
Saraswat
M Kumar
MK
Sharma
B Chander
BC
Sakhuja
P
P
Sarin
S K
SK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000473:pathology* / Q000517:prevention & control; D002648:Child; D005260:Female; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000600:supply & distribution; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007194:India / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000473:pathology*; D008113:Liver Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies
D017325:Hepatitis B Vaccines