Characteristics of hepatocellular carcinoma in India: A retrospective analysis of 191 cases

Abstract

Background: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide. The outcome of the disease is related to the stage of presentation. A comprehensive analysis of patients with this disease is not available in India. Methods: Retrospective chart review of 246 patients with HCC was done. One hundred ninety-one patients (male 160, female 31; median age 52 years, range 9-85 years) fulfilling diagnostic criteria for HCC adopted by Barcelona-2000 EASL conference were analyzed for clinical, etiological, radiological and cytohistological profile. Results: Underlying cirrhosis was seen in 60% cases with hepatitis B being the most common etiologic agent. HCC caused new onset ascites and recent worsening in three-fourth cases with ascites. Paraneoplastic syndrome was a rare event in HCC in India. Diagnostic level of serum AFP was seen in only 46% with significant difference between cirrhosis HCC patients compared with non-cirrhosis HCC patients (53% vs. 26%; P = 0.046). Most cases (83%) presented at advanced stage (Okuda III or IV) and cytohistology was the best method to diagnose HCC. Vascular invasion was seen in half the patients (53%) by the time they presented with extrahepatic spread of tumor in 13% cases. Conclusions: The prevalence of advanced stage HCC makes most of the detectable lesions unsuitable for curative resection. However, universal hepatitis B vaccination program may become the most effective preventive measure to control this disease in India. © The Author 2008. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved.