Clinical Profile Of Hepatocellular Carcinoma-Experience At A Tertiary Care Hospital

Abstract

Objective: To determine the characteristics of Hepatocellular carcinoma (HCC) in patients visiting PEMH Rawalpindi.
Study Design and Setting: Cross-sectional Study conducted at Department of Gastroenterology/hepatology in Pak Emirates
Military Hospital Rawalpindi (PEMH) from Oct 2015 to Jan 2018.
Methodology: In this study total 100 patients, with HCC of both genders were included. All the cases were discussed in
multidisciplinary team (MDT) meetings which were held once every week. A decision on the best possible management
for the given case was arrived at in the MDT meeting. All the relevant features of each case were recorded in the Performa.
Descriptive statistics were used to calculate mean, standard deviation and frequencies for gender, various presenting features,
co-morbidities and clinical features. Data was analyzed on SPSS version 21. P value <0.05 was considered as statistically
significant.
Results: Sixty seven men and 33 women with HCC were included in this study with a mean age of 58.23 years. The
abdominal pain was the most common symptom present in 66 (66%) patients. Edema was seen in 30 (30%) and palpable
splenomegaly in 26(26%). Diabetes mellitus was the most common co-morbidity found in 20(20%) patients. HCV was
the commonest cause of HCC present in 79(79%) patients. Vascular involvement was seen in 15 (15%) patients. Most
(62%) patients had a single HCC lesion and most belonged to Child –Pugh class A (68%) and BCLC stage B (42%). ECOG
performance status was good in most patients with 49% patients scoring 0. The AFP levels were raised in 58 (58%) of the
patients.
Conclusion: HCV was the most common underlying etiology. Most of the patients were asymptomatic at the time of
diagnosis. Majority of subjects reported with the complaint of abdominal pain and had no underlying co morbidity. The
metastasis was negative in majority of cases.