DEMOGRAPHICS AND CORRELATION OF RISK FACTORS FOR HEPATOCELLULAR CARCINOMA IN PATIENTS PRESENTING TO A TERTIARY CARE FACILITY IN PAKISTAN

Objective: Demographics of HCC in Pakistan. Correlation of HCC with its possible etiology. Correlation of tumor aggressiveness with PCR status and anti-viral treatment. Study Design: Cross sectional study. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi from Jul 2017 to Jun 2018. Methodology: Patients with age >18 years presenting with space occupying lesion(s) of liver were confirmed to be HCC according to standard guidelines. The variables such as age, gender, presence of cirrhosis, etiology of cirrhosis, tumor staging, viral status through PCR study and the treatment offered were documented. Baseline descriptive data was reported as mean with SD for continuous variables. Chi square test was used to compare qualitative data. Results: A total of 195 patients were enrolled for one year. Male population with HCC was in predominance (75.9%). Sixty one percent of the afflicted population was having liver cirrhosis, 34.9% had decompensated cirrhosis and 3.8% had no cirrhosis. HCV accounted for the bulk of patients with cirrhosis (82%) followed by HBV (9.2%), HBV and HCV co-infection (3.1%), NASH and cryptogenic cirrhosis (1.5% each). Majority got diagnosed with triphasic CECT scan Abdomen, only 3.6% needed liver biopsy for diagnosis. Majority (43.6%) belonged to BCLC B. Viral PCR was positive for 58.5% and 73.8% of the patients were treatment naïve. Conclusion: HCC shows highest rates seen in male patients presenting in old age. Gender, classes of cirrhosis, number of lesions, portal vein thrombosis and extrahepatic metastasis correlated with possible risk factors of HCC. Tumor aggressiveness correlated with PCR status.............