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Alswat KA, Sanai FM, Altuwaijri M, et al. Clinical characteristics of patients with hepatocellular carcinoma in a middle eastern population. Hepat Mon. 2013;13(5):e7612doi: 10.5812/hepatmon.7612.
Alswat, K. A., Sanai, F. M., Altuwaijri, M., Albenmousa, A., Almadi, M., Al-Hamoudi, W. K., & Abdo, A. A. (2013). Clinical characteristics of patients with hepatocellular carcinoma in a middle eastern population. Hepatitis monthly, 13(5), e7612. https://doi.org/10.5812/hepatmon.7612
Alswat, Khalid A, et al. "Clinical characteristics of patients with hepatocellular carcinoma in a middle eastern population." Hepatitis monthly vol. 13,5 (2013): e7612. doi: https://doi.org/10.5812/hepatmon.7612
Alswat KA, Sanai FM, Altuwaijri M, Albenmousa A, Almadi M, Al-Hamoudi WK, Abdo AA. Clinical characteristics of patients with hepatocellular carcinoma in a middle eastern population. Hepat Mon. 2013 May 08;13(5):e7612. doi: 10.5812/hepatmon.7612. Print 2013 May. PMID: 23922558; PMCID: PMC3732662.
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Hepat Mon. 2013 May 08;13(5):e7612. doi: 10.5812/hepatmon.7612. Print 2013 May.

Clinical characteristics of patients with hepatocellular carcinoma in a middle eastern population.

Hepatitis monthly

Khalid A Alswat, Faisal M Sanai, Mansour Altuwaijri, Ali Albenmousa, Majid Almadi, Waleed K Al-Hamoudi, Ayman A Abdo

Affiliations

  1. Department of Medicine, Liver Disease Research Center, King Saud University, Riyadh, Saudi Arabia.

PMID: 23922558 PMCID: PMC3732662 DOI: 10.5812/hepatmon.7612

Abstract

BACKGROUND: Hepatocellular carcinoma (HCC) is one of the leading causes of death in Saudi male patients. Local clinical and demographic data of this disease are scarce.

OBJECTIVES: We sought to describe the clinical characteristics and outcomes of patients from two tertiary care centers in Saudi Arabia.

PATIENTS AND METHODS: Data were collected for all patients diagnosed to have hepatocellular carcinoma between June 2003 and July 2008 who had been registered in a special research database (the Saudi Observatory Liver Disease Registry (SOLID)). Data were extracted from SOLID for clinical, biochemical, radiologic parameters and outcome.

RESULTS: Data was available for 363 patients, the mean age of diagnosis was 66 years, 74% of patients were males, and Hepatitis C was the underlying cause of liver disease in 48%, while Hepatitis B in 29%. Most of the patients were diagnosed at an advanced stage, 53 % of patients had a CLIP score of 4 to 6 (advanced stage), 55% had large multi-nodular tumors and 16% had vascular invasion or extra-hepatic spread at the time of diagnosis. Most of the patients had decompensated cirrhosis; with child-pogh score B in 44% and C in 26% with presence of portal hypertension in 55%. Forty eight percent died during the study period. Predictors of poor survival in the univariate analysis were; presence of portal vein thrombosis (P = 0.03), portal hypertension (P < 0.0001), presence of ascites (P = 0.022), hepatic encephalopathy (P < 0.0001), advanced child-pough score (P < 0.0001), bilirubin > 22 (P < 0.0001) and INR > 1.2 (P = 0.02). On multivariate analysis, only the presence of portal hypertension, bilirubin > 22 and severe hepatic encephalopathy were significant with adjusted hazard ratio of 1.6 (95% CI; 1.04-2.47), 1.76 (95% CI; 1.12-2.8), and 3.18 (95% CI; 1.42-7.14) respectively.

CONCLUSIONS: The data from this cohort indicates that most of patients diagnosed with HCC present at late tumor and liver disease stages, when prognosis is usually dismal. Regular cancer surveillance in cirrhotic patients might change the outcomes. Further studies with results of treatment outcomes in this community are needed.

Keywords: Alpha-Fetoproteins; Carcinoma, Hepatocellular; Hepatitis B; Hepatitis C; Saudi Arabia

References

  1. Ann Saudi Med. 1992 May;12(3):283-5 - PubMed
  2. J Gastroenterol Hepatol. 2004 Jun;19(6):665-9 - PubMed
  3. Int J Infect Dis. 2010 Feb;14(2):e115-20 - PubMed
  4. J Natl Cancer Inst. 1965 Nov;35(5):729-57 - PubMed
  5. Cancer Res. 1993 Feb 15;53(4):790-4 - PubMed
  6. Gastroenterology. 2004 Nov;127(5 Suppl 1):S35-50 - PubMed
  7. Saudi J Gastroenterol. 2007 Jan-Mar;13(1):45-8 - PubMed
  8. HPB (Oxford). 2003;5(4):243-50 - PubMed
  9. Cochrane Database Syst Rev. 2003;(2):CD002799 - PubMed
  10. Ann Saudi Med. 2003 Nov-Dec;23(6):367-71 - PubMed
  11. Cancer. 1985 Apr 1;55(7):1579-85 - PubMed
  12. Hepatology. 2005 Nov;42(5):1208-36 - PubMed
  13. J Cancer Res Clin Oncol. 2004 Jul;130(7):417-22 - PubMed
  14. Hepatology. 1991 Aug;14(2):215-8 - PubMed
  15. Lancet. 1981 Nov 21;2(8256):1129-33 - PubMed
  16. Saudi J Gastroenterol. 1996 May;2(2):87-90 - PubMed
  17. Hepatol Int. 2008 Mar;2(1):95-101 - PubMed
  18. Trans R Soc Trop Med Hyg. 1987;81(2):219-21 - PubMed
  19. J Clin Gastroenterol. 2001 Aug;33(2):123-6 - PubMed
  20. Saudi J Gastroenterol. 2002 Sep;8(3):81-4 - PubMed
  21. N Engl J Med. 1993 Jun 24;328(25):1797-801 - PubMed
  22. Semin Liver Dis. 1999;19(3):329-38 - PubMed
  23. Saudi Med J. 2003 Jul;24 Suppl 2:S81-6 - PubMed
  24. J Clin Oncol. 2011 Sep 20;29(27):3643-50 - PubMed
  25. World J Gastroenterol. 2005 Sep 7;11(33):5193-8 - PubMed
  26. Lancet. 1999 Apr 10;353(9160):1253-7 - PubMed
  27. Infection. 1986 Sep-Oct;14(5):223-5 - PubMed
  28. Ann Saudi Med. 1991 Sep;11(5):497-500 - PubMed
  29. Gastroenterology. 2004 Apr;126(4):1005-14 - PubMed
  30. J Med Virol. 1985 Nov;17(3):267-74 - PubMed
  31. Lancet. 1989 Oct 28;2(8670):1004-6 - PubMed
  32. Hepatology. 2003 Jul;38(1):258-66 - PubMed
  33. J Hepatol. 2012 Apr;56(4):908-43 - PubMed
  34. Ann Saudi Med. 1993 May;13(3):231-6 - PubMed
  35. Hepat Mon. 2012 Oct;12(10 HCC):e6023 - PubMed
  36. Vaccine. 2008 Nov 18;26(49):6266-73 - PubMed
  37. World J Gastroenterol. 2004 Jun 1;10(11):1547-50 - PubMed
  38. Ann Saudi Med. 2012 Mar-Apr;32(2):174-99 - PubMed
  39. Aliment Pharmacol Ther. 2007 Feb;25 Suppl 1:11-6 - PubMed
  40. J Hepatol. 1999 Jul;31(1):133-41 - PubMed
  41. Gastroenterology. 2007 Jun;132(7):2557-76 - PubMed
  42. J Infect. 1992 Mar;24(2):197-206 - PubMed
  43. Eur J Gastroenterol Hepatol. 2009 Oct;21(10):1212-8 - PubMed
  44. Hepatology. 2000 Oct;32(4 Pt 1):842-6 - PubMed
  45. Hepatology. 2011 Mar;53(3):1020-2 - PubMed
  46. J Infect. 2008 Nov;57(5):404-9 - PubMed
  47. Am J Gastroenterol. 1999 Nov;94(11):3285-91 - PubMed
  48. Hepatology. 2000 Apr;31(4):840-5 - PubMed
  49. Gastroenterology. 2004 Nov;127(5 Suppl 1):S5-S16 - PubMed
  50. Science. 2007 Jul 6;317(5834):121-4 - PubMed

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