Hepatocellular carcinoma: epidemiological profile from a cohort of federal employees in Mexico.
BACKGROUND
Hepatocellular carcinoma (HCC) has become a frequent type of cancer in Mexico. At the present time it represents the 19th cause of death in the population.


OBJECTIVE
To recognize the epidemiological profile and the treatment results in a cohort of federal employees with HCC.


METHODS
We analyzed 47 consecutive cases with HCC diagnosis from January 2004 till December 2007. Twenty four demographic data, tumor staging, clinical, and biochemical variables were analyzed to identify parameters predicting survival by computing Kaplan-Mier and Mantel-Cox survival curves.


RESULTS
Patient reference increased 5% each year. The mean age was 60.4 years, 63.8% female sex, and 72.3% had cirrhosis, 44.7% had Hepatitis C infection. Most patients presented with advanced disease: 55.3% were AJCC stage 3 and 21.3% stage 4, 51.1% were BCLC class D. Mean tumor size was 8.09 cm. Median survival time from diagnosis was 122 days. Patients that did not receive treatment had a median survival of 70 days; the longest survival of patients was of those that received transarterial chemoembolization with a median of 707 days, followed by surgery with 683 days. Univariate analysis showed survival was associated to MELD score, AJCC and BCLC staging, creatinine level and ascites. Multivariate analysis showed tumor differentiation, AJCC staging and the choice of treatment to be related to the risk of death.


CONCLUSIONS
An increase in the referral of HCC was demonstrated. Most patients had cirrhosis and HCV infection. Due to advance disease staging, TACE was the treatment that offered longest survival.
Ladrón de Guevara
Laura
L
Programa de Trasplante Hepático, ISSSTE, México D.F., México. lauraldeg@yahoo.com
Rojas-Macuil
Paulo
P
Sánchez-Chávez
Xochiquetzal
X
Rossano-García
Alejandro
A
Gorraez-de-la-Mora
Ma Teresa
MT
Cervantes-Sánchez
Guadalupe
G
Orozco-Vázquez
Julita
J
Lemus-Velázquez
Mario
M
Rosas-Zúñiga
Leticia
L
Erazo-Valle
Aura
A
Di-Silvio
Mauricio
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000208:ethnology / Q000628:therapy; D016461:Chemoembolization, Therapeutic; D015331:Cohort Studies; D035082:Federal Government; D005260:Female; D005500:Follow-Up Studies; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000628:therapy; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D016272:Occupational Health; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome