title: Hepatocellular carcinoma in qatar.
abstract: OBJECTIVE
  The main aim of this study was to report and discuss epidemiological, etiological, type of treatment and data on survival of the patients with each mode of treatment using available data for patients with hepatocellular carcinoma (HCC) who have been diagnosed at Hamad Medical Corporation during the period March 2004-December 2010 inclusive.
  
  
  METHODS
  Retrospective analysis of 150 patient's data had been done, including demographic, epidemiological, etiological disease status assessment with child Pugh criteria, modes of treatment and treatment related outcome. Patient's various characteristics such as demographic, epidemiological, and other clinical characteristics were summarized using an appropriate descriptive statistics. Univariate Kaplan-Meier survival curve analysis was performed to estimate overall and group wise survival at different time points. Furthermore, the log-rank test was applied to determine any statistical difference in survival among various subgroups. In addition, the multivariate Cox regression method was used to assess the significant effects of various prognostic factors on outcome survival time.
  
  
  RESULTS
  The mean age of the studied HCC patients was 58.8 years (31-87years) with a male: female ratio of 3:1 (76% Male 24% Female). There were 48 (32%) Qatari and 102 (62%) non-Qatari patients. The underlying etiology HCV was the most common (45%) similar to Western European countries, HBV in (27%), alcoholic liver disease only in 6 (4%), Child-Pugh assessment was A in (33%), B in (37%) and C in (30%), nearly half of the patients (53%) were in advanced stage and had palliative treatment, the other half had chemoembolization in (17%), systemic therapy sorafenib in (13%), surgery (liver resection or transplantation) in (12%) and local ablation in (5%).
  
  
  CONCLUSIONS
  HCC is more common in males (ratio M:F 3:1). HCV is the most common underlying cause, similar to the pattern in western European countries. The survivals in our patient were comparable to other studies reported in the literature. Patients who had chemoembolization had the longest median survival [Median = 27 months, 95% CI (20.27- 33.72). Majority of cases (53%) were diagnosed at advanced stage. To improve the outcome of treatment of HCC patients, the number of early and very early stage diagnosis should be increased by improving the implementation and effectiveness of the strategic screening program.
  
  
  BACKGROUND
  Hepatocellular carcinoma, chemoembolization, radiofrequency, sorafenib, hepatitis C, Hepatitis B.
authors.affiliation: Kakil Ibrahim Rasul, CABM, FRCP, ESMO certified, Senior Consultant Haem/Oncolgy, Al-Amal Hospital, Hamad Medical Corporation, P.O.Box 3050, Doha, Qatar. Email: kakil954@yahoo.com.
authors.forename: K I
authors.initials: KI
authors.lastname: Rasul
authors.forename: S H
authors.initials: SH
authors.lastname: Al-Azawi
authors.forename: P
authors.initials: P
authors.lastname: Chandra
mesh_terms: D006528:Carcinoma, Hepatocellular; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms; D011780:Qatar; D012189:Retrospective Studies