Profile of hepatocellular carcinoma in a tertiary care hospital in Punjab in northern India.
OBJECTIVE
Hepatocellular carcinoma (HCC) is a major cause of morbidity and mortality in all parts of the world. We analyzed the clinical presentation, etiology, and tumor characteristics of HCC presenting to our hospital.


METHODS
All patients diagnosed to have HCC from September 2007 to August 2010 were prospectively enrolled. HCC was diagnosed according to EASL criteria-USG/CT/MRI of the abdomen and/or serum alpha-fetoprotein and/or histology (where indicated). Detailed clinical and laboratory parameters were noted. Barcelona Clinic Liver Cancer (BCLC) staging was done.


RESULTS
One hundred and twenty-eight patients (22 females, mean ± SD; age, 49.8 ± 10.2 years) were diagnosed to have HCC. Underlying cirrhosis was present in 99.2 %. Hepatitis C virus infection, alone (21.9 %) or with alcohol (22.9 %) was the most common etiological factor, followed by alcohol alone; 33.6 % of the patients had more than one etiological factor. Most patients (83.5 %) presented with features of decompensated cirrhosis. HCC leading to decompensation of cirrhosis was the first presentation of the liver disease in nearly one third of the cases. Serum alpha-fetoprotein was >200 ng/mL in 67.2 % of the patients, while it was normal in 18.7 % of the patients. The mean ± SD size of HCC was 5.3 ± 2.9 cm. HCC was multicentric in 57 %, and portal vein thrombosis was present in 34.4 %. About 66 % of the patients belonged to BCLC stage C or D.


CONCLUSIONS
Hepatitis C virus infection was the most common cause of HCC in Punjab. One-third of the patients had multiple etiological factors and almost all had underlying cirrhosis and presented at advanced stage.
Department of Gastroenterology, Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana, 141 001, India, ajitsood10@sify.com.
Ajit
A
Sood
Vandana
V
Midha
Omesh
O
Goyal
Prerna
P
Goyal
Neena
N
Sood
Suresh Kumar
SK
Sharma
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D005260:Female; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology*; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D007194:India / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000150:complications / Q000453:epidemiology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D064887:Observational Studies as Topic; D011446:Prospective Studies; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D013997:Time Factors; D020246:Venous Thrombosis; D000509:alpha-Fetoproteins / Q000032:analysis
D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins