Authors: Boua-Akelelo NP, Youssouf O, Ignaléamoko Word NE, Mofini E, Elowa JB, Bessanguem B, Komaria H, Armand, Yangba Kalebanga AOT, Service G, Camengo Police SM.
Introduction: Hepatocellular carcinoma (HCC) is a public health problem. It is the most frequent cause of death in patients with decompensated cirrhosis [1].
Objective: To help improve the management of hepatocellular carcinoma (HCC).
Patients and Methods: We conducted a cross-sectional analytical study covering the period from 1er January 2020 to 31 October 2022 in the Hepato-Gastroenterology Department of the Centre Hospitalier Universitaire de l'Amitié Sino-centrafricaine (CHUASC) in Bangui. We included in the study patients of both sexes aged at least 18 years with a diagnosis of HCC due to hepatitis B virus (HBV). Patients were divided into two groups (HCC without cirrhosis and HCC with cirrhosis). The study variables were epidemiological, clinical, biological and morphological. Data were entered and analysed using Epi Info version 7 software. The Chi2 test was used for comparison, with a significance level of p ? 0.05.
Results: During the study period, 1344 patients were hospitalised, of whom 681 had chronic liver disease (51%), 288 cases (42.30%) had cirrhosis and/or HCC due to HBV. The hospital incidence of HCC and HCC on cirrhosis was 7.59%. We identified 68 patients (23.61%) with HCC due to cirrhosis (sex ratio: 3.85) and 34 patients (11.80%) with HCC without cirrhosis (sex ratio: 5.8). The mean age of patients with HCC on cirrhosis was 45±11 years and that of patients with HCC without cirrhosis was 48±12 years. In both groups, half of the patients had WHO performance status 3. The alpha-fetoprotein value was ≥ 400 IU/ml in 61.5% of patients with HCC in cirrhosis and in 17.3% of patients with HCC without cirrhosis. Morphologically, the liver was enlarged, multiheteronodular and hypervascularised on Doppler ultrasound and abdominal CT. According to the BCLC (Barcelona-Clinic Liver Cancer) classification, patients with HCC in cirrhosis were stage C in 9 cases (13.23%) and stage D in 59 cases (88.14%). The Okuda classification used to assess the severity of HCC in the 34 patients classified them as stage 2 in 11 cases (32.35%) and stage D in 23 cases (67.65%).
Conclusion: HCC occurs very frequently in young adults with viral B cirrhosis. It is diagnosed late in patients with several nodules that do not allow curative treatment.
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