title: Status of hepatocellular carcinoma in Gulf region.
abstract: Hepatocellular carcinoma (HCC) has a unique geographic distribution that is likely to be determined by specific etiologic factors. There is a distinctive difference in sex and age related occurrence of disease. In the Gulf region, there are contradicting data on the prevalence and death rates due to HCC. In this review we highlight some aspects of HCC specific to the Gulf region. A retrospective analysis of 150 patient's data is presented, including demographic, epidemiological, aetiological disease status assessment with child Pugh criteria, modes of treatment and treatment related outcome. Hepatitis C virus (HCV) infection was the most common (45%) documented etiology, similar to Western European countries, followed by hepatitis B virus (HBV) infection in 27% of cases, alcoholic liver disease only in six patients (4%). Child-Pugh assessment was A in 33%, B in 37% and C in 30% of observed patients. Surgery (liver resection or transplantation) was performed in 12% and local ablation in 5% of cases. The others were treated by chemo-embolization in 17% and by systemic therapy with sorafenib in 13% of patients. Nearly half of the patients (53%) were in advanced stages and received palliative treatment. To improve the outcome of treatment in HCC patients in the Gulf region, an effective and strategic screening program must be implemented for early diagnosis and treatment to improve the outcome of this mostly fatal disease.
authors.affiliation: National Center for Cancer Care and Research, Doha, Weill Medical College at Cornell University Qatar, Doha, Qatar. krasul@hmc.org.qa.
authors.forename: Kakil Ibrahim
authors.initials: KI
authors.lastname: Rasul
authors.affiliation: National Center for Cancer Care and Research, Doha, Qatar.
authors.forename: Safaa H
authors.initials: SH
authors.lastname: Al-Azawi
authors.affiliation: Research Center at Hamad Medical Corporation, Doha, Qatar.
authors.forename: Prem
authors.initials: P
authors.lastname: Chandra
authors.affiliation: Memorial Sloan-Kettering Cancer Center, Weill Medical College at Cornell University, New York, NY, USA.
authors.forename: Ghassan K
authors.initials: GK
authors.lastname: Abou-Alfa
authors.affiliation: National Center for Cancer Care and Research, Doha, Qatar.
authors.forename: Alexander
authors.initials: A
authors.lastname: Knuth
keywords: Hepatocellular carcinoma (HCC); chemoembolization; hepatitis B; hepatitis C; radiofrequency; sorafenib