title: Clinical and epidemiological aspects of hepatocellular carcinoma in Brazil.
abstract: The global hepatocellular carcinoma (HCC) incidence is widely variable, depending on geographic region and the prevalence of major risk factors. In Brazil, two large multicentre retrospective studies were performed to investigate clinical and epidemiological aspects of HCC. In the first study, performed in 1997, HCC was found in cirrhotic livers in 71% of cases. Chronic alcoholism was present in 36% of cases, chronic hepatitis B in 35% and hepatitis C in 25%. In a 2010 survey, cirrhosis was present in 98% of cases and HCV was the main aetiology (54%). Differences in HBV prevalence were found among regions. Selection of HCC treatment depends on tumour burden, liver function and performance status. Liver transplantation (LT) is the best available curative treatment for HCC in its early stage and with compromised liver function. After modifications in priority policy, the number of patients with early HCC submitted for LT has increased in the past 5 years in Brazil. Chemoembolization is the most common initial HCC therapy in early and intermediate stages of HCC in Brazil.
authors.affiliation: São Paulo Clínicas Liver Cancer Group, Hospital das Clínicas, Instituto do Câncer do Estado de São Paulo, Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Luciana
authors.initials: L
authors.lastname: Kikuchi
authors.forename: Aline L
authors.initials: AL
authors.lastname: Chagas
authors.forename: Regiane Ssm
authors.initials: RS
authors.lastname: Alencar
authors.forename: Denise C
authors.initials: DC
authors.lastname: Paranaguá-Vezozzo
authors.forename: Flair J
authors.initials: FJ
authors.lastname: Carrilho
mesh_terms: D000368:Aged; D001938:Brazil / Q000453:epidemiology; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D016461:Chemoembolization, Therapeutic; D005260:Female; D019694:Hepatitis B, Chronic / Q000453:epidemiology*; D019698:Hepatitis C, Chronic / Q000453:epidemiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D016031:Liver Transplantation; D008297:Male; D012189:Retrospective Studies