Hepatocellular Carcinoma Presentation & Management , A Prospective Study in the Medical City Baghdad - Iraq
Iraqi Postgraduate Medical Journal,
2011, Volume 10, Issue 2, Pages 253-260
BACK GROUND :
The development of HCC is a major global health problem , It's incidence has increased world wide and nowadays it constitute the 5th most frequent cancer representing around 5% of all cancers, and estimated to rank 4th in terms of mortality of cancers incidence world wide , it accounts for 80 –90% of all primary liver tumors . The Etiology of this tumor is multifactorial , certain viral, environmental & hereditary causes of cirrhosis have a strong correlation with HCC . HCC is a highly malignant tumor with poor prognosis .
To evaluated the Etiological , Epidemiological , Patho physiological , Diagnostic series , Therapeutic approaches & Advanced studies in detection and prevention of HCC .
PATIENTS AND METHODS :
Across sectional study of (57) patients with HCC ( 43 males , 14 females ) during the period from January 2000 to December 2002 . The patients were collected from medical & surgical units of Baghdad teaching hospital & the gastroenterology & hepatology teaching hospital .
History taken from these patients & physical examination , Lab investigation ,CBP, liver function test ,Virology study , serum AFP. Titer ,U/S study , MRI , CT scan . Ascitic fluid tapping , Liver biopsy.
Modalities of treatment : Palliative Treatment, Chemotherapy, Injection of Alcohol , Hemilobectomy ,Segmental resection , Debulking resection of tumor in the liver, Conservative treatment , any complications or hazards during surgical procedures were recorded.
Male to female ratio is approximately (3:1), The mean age of (57.1) yr . more common between (51-60) yrs old ( 28.25% ) , Most of the patients were from Baghdad ( 47.4% ) . Increasing no. of patients from 2000 ( 21.1 % ) to 2002 ( 45.6 % ). (84% ) have previous history of chronic liver disease & (16%) haven't such a history . Most of chronic liver diseases are due to previous history of hepatitis B- infection (41.6%) . High level of AFP ( 66.6% ), all of them are of standard type of HCC. Ascitic fluid cytological study bloody (14%) & positive malignant cells (17.2%) . Liver biopsy (82.7%) had chronic liver diseases, and (96.5%) moderate to poorly differentiated type of standard HCC,(3.5%) fibrolamellar type .Outcome of treatment , Conservative (35%), Injection therapy (3.5%) , Chemotherapy (28%), Surgical procedures (16%) , Segmental & Right lobectomy (3.5%) for each , Debulking (9%) .
AFP and U/S study are very important in the early detection and follow up of the patient with HCC , Liver biopsy - very important study to detect various type of HCC , Surgical resection is the only potentially curative treatment of HCC
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