title: Epidemiological aspects of hepatocellular carcinoma in a referral center of Minas Gerais, Brazil.
abstract: BACKGROUND
  Studies on epidemiology of hepatocellular carcinoma and modalities of therapy used to treat this condition are scarce in Brazil. Our aim was to characterize hepatocellular carcinoma according to etiology of the underlying chronic liver disease, and treatment modalities, in a referral center in Brazil.
  
  
  METHODS
  All cases of hepatocellular carcinoma registered in the Department of Pathology during a 12-year period (1998-2010) were included. Demographic data, etiology of the underlying liver disease and treatment performed were collected.
  
  
  RESULTS
  This case series included 215 patients, mean age 57.3 (±14.1) years, 164 (76.2 %) male. Virus C and virus B infection were detected in 88 (43%) and 47 (23%) patients, respectively. Ethanol abuse alone or combined with other etiologies was identified in 64 (32%) individuals. Schistosomiasis was found in 18 (9%) patients. Liver transplantation was the treatment of choice in 112 (51%) patients. This procedure was more frequently performed in hepatitis C virus-related hepatocellular carcinoma (70%) than B virus-related hepatocellular carcinoma (17%). Tumor resection was performed in 40 (18%) individuals, ethanol injection or thermo ablation in 18 (14%), and chemoembolization in 14 (7%). In 40 (19.4%) patients no treatment was performed and this percentage remained constant over the years.
  
  
  CONCLUSIONS
  Chronic hepatitis C, followed by ethanol abuse and chronic hepatitis B were the leading causes of underlying chronic liver disease associated with hepatocellular carcinoma. The results show a trend of increasing incidence of hepatocellular carcinoma; however, the proportion of untreated patients remained constant over the analyzed period.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Fernanda Maria Farage
authors.initials: FM
authors.lastname: Osório
authors.forename: Gabriel Martin
authors.initials: GM
authors.lastname: Lauar
authors.forename: Agnaldo Soares
authors.initials: AS
authors.lastname: Lima
authors.forename: Paula Vieira Teixeira
authors.initials: PV
authors.lastname: Vidigal
authors.forename: Teresa Cristina Abreu
authors.initials: TC
authors.lastname: Ferrari
authors.forename: Claudia Alves
authors.initials: CA
authors.lastname: Couto
mesh_terms: D000437:Alcoholism / Q000150:complications*; D001938:Brazil / Q000453:epidemiology; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006509:Hepatitis B / Q000150:complications*; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000209:etiology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012552:Schistosomiasis / Q000150:complications*