Characterization, management and prognosis of a cohort of cirrhotic patients with hepatocellular carcinoma. Pablo Tobón Uribe Hospital 2012-2018

Abstract

Introduction. Hepatocellular carcinoma (HCC) in patients with liver cirrhosis is a frequent indication for liver transplantation and a cause of death if not diagnosed promptly. The aim of this study was to describe the demographics, and clinical and laboratory characteristics of patients with HCC in a cirrhotic liver, as well as the stage at the time of diagnosis, type of treatment offered, and survival, according to BCLC classification. Methodology. Retrospective observational cohort study, which included patients treated at a center in Colombia between January 1 2012 and December 31 2018, aged ≥18 years, with hepatocarcinoma. Information was collected from medical records. Collected data was analyzed using SPSS 23.0. Results. We included 219 patients with HCC and underlying liver cirrhosis. Males were 58.9% and median age was 65 years. Etiological distribution of cirrhosis for alcohol, non-alcoholic steatohepatitis (NASH), cryptogenic, and hepatitis B and C viral infection was 30.6%, 21.4%, 19.1%, 12.2% and 7.7%, respectively. At diagnosis, 49.3% had Child-Pugh A score, 37% B and 13.7% C. BCLC classification was distributed as follows: 0=4 (1.8%), A=94 (42.9%), B=26 (11.9%), C=39 (17.8%) and D=56 (25.6%). Survival, according to BCLC classification, was for BCLC 0=60 months, A=84.6 months, B=28.7 months, C=10.7 months and for BCLC D=7 months. Conclusion. Despite finding better survival in this series, compared to that found in another series from our center in 2009, and similar to that reported worldwide, a delayed diagnosis continuesto be the main cause of mortality in patients with HCC.