Clinical Profile, Risk Factors, and Treatment of Hepatocellular
Carcinoma in Nepal: A Single Centre Experience
Abstract
Background Hepatocellular carcinoma (HCC) is the most common primary
liver cancer. Liver cancer is one of the commonest cancers worldwide in
terms of incidence and mortality. Viral hepatitis, alcohol abuse, and
autoimmune hepatitis are the common causes of HCC. Usually patients
present at advanced stages where curative treatment is no longer
possible. This study aims to analyze the demographic, clinical, and
radiological profiles and treatment patterns of HCC patients. Methods We
studied patients with HCC from March 2020 to August 2022 and analyzed
their risk factors, clinical characteristics, and treatment modalities.
Patients with at least one clinical, radiological, or biochemical
evidence of HCC were considered for the study. Data were collected using
predetermined proformas. Results Our study included 54 patients with a
mean age of 57.17 years, and male: female ratio of 5:1. Of them, 68.52%
consumed alcohol and 74.07% smoked cigarettes. At the time of
diagnosis, 88.89% of them were symptomatic, weight loss (64.81%) being
the most common symptom. The majority of the participants belonged to
Barcelona Clinic Liver Cancer (BCLC) terminal stage (38.89%) and had
more than three liver lesions (35.19%) involving the right lobe
(55.56%). Only four patients underwent curative surgical resection. As
most were in the terminal stage (BCLC D), supportive care was provided.
Conclusion Alcohol-related liver cirrhosis is the most common cause of
HCC in Nepal. Despite the significant progress in diagnostic methods,
most of the patients are diagnosed at advanced and terminal stages.
These patients are unsuitable for curative treatment and are treated
with supportive methods. Keywords Autoimmune hepatitis, hepatitis,
hepatocellular carcinoma, treatment.