title: Epidemiology and survival of hepatocellular carcinoma in Turkey: outcome of multicenter study.
abstract: OBJECTIVE
  Hepatocellular cancer (HCC) is one of the important health problems in Turkey. We aimed to determine the clinical and demographic features of HCC in the Turkish population and to evaluate the prognostic and survival features.
  
  
  METHODS
  Two hundred and twenty-one patients with HCC from five hospitals in Turkey are included in this study.
  
  
  RESULTS
  In 44.4% of the 221 patients with hepatitis B virus and in 21.3% of the 221 patients with hepatitis C virus were found to be responsible for HCC etiology. It has been shown that HCC developed on cirrhosis basis in 74.2% of the patients. HCC was presented with single solitary nodule in 69.2% of the patients. Non-liver metastasis was present in 12.5% of the patients. In 21.7% of the patients, alpha-fetoprotein (AFP) levels were above the diagnostics level of 400 ng/ml. The median overall survival (OS) of 221 patients was 14 months. The median OS of the patients with Child-Pugh A class was significantly longer than that with Child-Pugh B and C classes. The OS of the individuals with normal AFP levels was also longer than that with high AFP levels. The OS of the patients with Stage I HCC according to tumor node metastasis (TNM) classification, the female patients and the treated patients group was found to be significantly good.
  
  
  CONCLUSIONS
  In conclusion, the viral etiology (hepatitis B and C infections) in Turkish population is found to be an important factor in HCC development. The Child-Pugh classification, AFP levels, TNM classification, being female and treatment were determined to be important prognostic factors in HCC patients.
authors.affiliation: Dokuz Eylul University, Institute of Oncology, Balcova, Izmir, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Alacacioglu
authors.forename: Isil
authors.initials: I
authors.lastname: Somali
authors.forename: Ilkay
authors.initials: I
authors.lastname: Simsek
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Astarcioglu
authors.forename: Metin
authors.initials: M
authors.lastname: Ozkan
authors.forename: Cemalettin
authors.initials: C
authors.lastname: Camci
authors.forename: Necati
authors.initials: N
authors.lastname: Alkis
authors.forename: Aziz
authors.initials: A
authors.lastname: Karaoglu
authors.forename: Oktay
authors.initials: O
authors.lastname: Tarhan
authors.forename: Tugba
authors.initials: T
authors.lastname: Unek
authors.forename: Ugur
authors.initials: U
authors.lastname: Yilmaz