Hepatocellular carcinoma in Mansoura Egypt: Experience of 385 patients at a single center

Background/Aims: Hepatucellular carcinoma is one of the commonest malignanc ies in the world. The two main etiological factors for hepatocellular carci noma are cirrhosis and viral hepatitis. Although the first choice of treatm ent for hepatocellular carcinoma is surgical resection, most of them are un resectable at the time of diagnosis. Methodology: From January 1994 to June 1999, 385 patients with hepatocellul ar carcinoma were presented to the Gastroenterology surgical center, Mansou ra University, Egypt and subjected to similar diagnostic process. Forty-fiv e (11.6%) of these patients (34 males and 13 females) with a mean age of 50 .9 years (+/-7.53 years) were subjected to different types of hepatic resec tion. Results: The underlying liver pathology was cirrhosis in 85%. Positive viro logy was found in 82.5% (HCV 61%, HBV 14.5% and combined 7%). The main pres entation were asymptomatic in 144 (37.4%)) patients, abdominal pain in 92 ( 23.9%) patients, ascites in 95 (24.6%) patients, jaundice in 53 (14%) patie nts and upper gastrointestinal hemorrhage in 26 (6.75%) patients. Only 45 ( 11.6%) were resectable, they were subjected to hepatic resection with opera tive mortality in 2 cases (4.4%) and with overall mortality in 29 (64.4%) c ases after 48 months (32.8+/-19 months) of follow-up. The main causes of la te mortality were recurrence in 14 (31.1%) cases, hepatic cell failure in 7 (15.5%) cases and other causes in 6 (13.3%). Conclusions: Hepatocellular carcinoma is now a common malignancy in Egypt, which usually develops on top of cirrhosis of viral origin in 82%(.) Hepati c resection is the only method of treatment with a low resectability rate.