EPIDEMIOLOGY OF HEPATOCELLULAR-CARCINOMA IN THE DEPARTMENT OF CALVADOS

Objectives. - The aim of this study was to determine the epidemiologic al characteristics of hepatocellular carcinoma in a non-selected popul ation. Methods. - Between 1984 and 1990, all cases of hepatocellular c arcinoma were registered at the Registry of Digestive Tumors of Calvad os. Standardized incidence rates were calculated for males and females . Prognostic factors were determined by the cox multivariate method. R esults. - 213 patients with hepatocellular carcinoma were registered. Standardized incidence rates were 7.5/100000 in men and 0.4/100000 in women. Sex-ratio was 18.3. Mean age was 66.4 years; hepatocellular car cinoma was uncommon (3%) before the age of 50. Cirrhosis was associate d in 85.9% of patients. The cause of cirrhosis was known in 150 cases: alcoholic: 73.3%, cryptogenetic: 8.7%, viral B or C: 7.3%, alcoholic and viral B or C: 5.3 %, and genetic hemochromatosis: 4.7%. The overal l survival rate in 203 patients was 21%, 8% and 3% at 1 year; 3 years and 5 years, respectively. The multivariate study identified 4 prognos tic factors: number of tumors less than or equal to 2, lack of ascites , serum alpha-fetoprotein less than or equal to 10 ng/mL, and hepatoce llular carcinoma revealing a well-compensated liver disease until the time of diagnosis. Conclusion. - The occurrence of hepatocellular carc inoma seems to be linked to cirrhosis, male sex, and age >50, which co uld be used as the main selection criterias for the screening of hepat ocellular carcinoma.