[Epidemiological, clinical and therapeutic features of hepatocellular carcinoma in cirrhotic patients].
BACKGROUND
Hepatocellular carcinoma (HCC) is the most frequent primitive hepatic tumor, the fifth most common cancer in the world,and the third highest cause of cancer-related mortality. The presence of cirrhosis is the main risk factor.


OBJECTIVE
To describe the epidemiological, clinical and therapeutic features of HCC.


METHODS
Retrospective study including all the patients with HCC occurring in cirrhotic liver followed in the gastroenterological department of Charles Nicolle hospital between 1997 and 2009.


RESULTS
A hundred and one patient were enrolled; 64 men and 37 women with a median age of 65.4 years (31-88 years). Cirrhosis was due to viral hepatitis B or C in 25.7% and 62.2% of cases respectively and was classified Child Pugh A, B and C in 30.7%,50.5% and 18.8% of patients respectively. HCC was inaugural in most cases (68.3 %) and it was revealed by a tumoral syndrome in 38.6% of cases, by decompensation in 22.7% and was discovered during systematic screening when cirrhosis was already known in 19.8% of cases. Diagnosis of HCC was non invasive, relying on imaging and alphafetoprotein in most cases (95%). 84 patients(83.2%) had an advanced HCC, with vascular or extra hepatic spread in 58 (57.5%) of them. Treatment was curative in 14 cases, based on surgical resection in one case and percutaneous ablation in 13 cases.Six patients received transarterial chemoembolization as a palliative treatment. In 71 patients, only symptomatic treatment was given. The median survival time was 11 months.


CONCLUSIONS
In the majority of the cases, HCC was diagnosed at an advanced stage and treatment was only symptomatic.
Hopital Charles Nicolle, Tunisie.
Yosra
Y
Said
Radhouene
R
Debbeche
Z
Z
Ben Ali
Kahena
K
Bouzid
Senda
S
Trabelsi
Slim
S
Bouzaidi
Mohamed
M
Salem
Hatem
H
Rajhi
Mohamed
M
Kouni Chahed
Taoufik
T
Najjar
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008113:Liver Neoplasms / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies