[Incidence of hepatocellular carcinoma and consequent lessons for its management in Northeastern Hungary].
BACKGROUND
The increasing incidence and poor prognosis of hepatocellular carcinoma places huge burden on healthcare.


OBJECTIVE
After reviewing literature on epidemiological trends, risk factors, diagnosis and management options for hepatocellular carcinoma, the authors investigated results of treatment and survival data of patients in Northeastern Hungary.


METHODS
In a retrospective study, the authors analyzed medical records of 187 patients with hepatocellular carcinoma (etiology, presence of cirrhosis, stage of the tumor, treatment and disease outcome).


RESULTS
Seventy-one patients (38%) had known cirrhosis at the diagnosis of hepatocellular carcinoma, while in 52 patients (28%) the presence of cirrhosis was established at the time of the diagnosis of hepatocellular carcinoma. Fifteen patients (8%) had no cirrhosis and in 49 patients (26%) no data were available regarding cirrhosis. Etiological factors were alcohol consumption (52%), viral hepatitis (41%) and metabolic syndrome (44%). In cases of metabolic syndrome, hepatocellular carcinoma frequently occurred without cirrhosis. In 83% of the cases, the tumor was discovered in an advanced stage. Median survival time was significantly associated with tumor stage (Barcelona A stage vs. B/C vs. D: 829 vs. 387 vs. 137 days, respectively p<0.001) but not with disease etiology (virus 282 days, metabolic syndrome 335 days and alcohol 423 days, p = 0.65).


CONCLUSIONS
High mortality of hepatocellular carcinoma was mainly attributed to the delayed diagnosis of the disease. Screening of patients with cirrhosis could only result in a partial improvement since in a great proportion cirrhosis was diagnosed simultaneously with the tumor. Screening of diabetic and obese patients by ultrasonography should be considered. Management of baseline liver disease is of importance in the care of hepatocellular carcinoma. Orv. Hetil., 2016, 157(45), 1793-1801.
Koch Róbert Kórház és Rendelőintézet Edelény.
Renáta
R
Papp
Belgyógyászati Intézet, Gasztroenterológia Nem Önálló Tanszék, Debreceni Egyetem, Általános Orvostudományi Kar Debrecen, Nagyerdei krt. 98., 4032.
Mária
M
Papp
Belgyógyászati Intézet, Gasztroenterológia Nem Önálló Tanszék, Debreceni Egyetem, Általános Orvostudományi Kar Debrecen, Nagyerdei krt. 98., 4032.
István
I
Tornai
Belgyógyászati Intézet, Gasztroenterológia Nem Önálló Tanszék, Debreceni Egyetem, Általános Orvostudományi Kar Debrecen, Nagyerdei krt. 98., 4032.
Zsuzsanna
Z
Vitális
D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D057210:Delayed Diagnosis; D018450:Disease Progression; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D015994:Incidence; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D012189:Retrospective Studies
Barcelona stage; Barcelona stádium; chronic liver disease; cirrhosis; hepatocellular carcinoma; hepatocellularis carcinoma; krónikus májbetegség; screening; szűrés