Demographic and clinical profile of adult Sri Lankans having hepatocellular carcinoma admitted to medical units of a tertiary referral center; 4 years experience
Abstract
Objective: To study the demographic and clinical profile of adult Sri Lankans having hepatocellular carcinoma.
Methods: Clinical notes of 42 patients having hepatoma admitted to medical units at Sri Jayawardenepura General Hospital, Kotte, Sri Lanka from January 2008 to January 2012 were retrospectively analyzed to obtain the required data.
Results: The age range was 43-91 years with a mean age of 65.5+/- 11.1 SD. Sex distribution was male: female; 38:4 (9:1). 90.5% were alcoholics. 57.1% had established liver disease at the time of diagnosis. 27.7% of patients with undiagnosed liver disease at presentation had radiological evidence of cirrhosis. On presentation ascites, abdominal pain, hepatic encephalopathy, anorexia and weight loss were found in 38.1%, 19%, 19%, 16.7% and 14.7% respectively. Uni-focal tumors were found in 61.9%. Secondaries were seen in 11.9%. The detectable sites were lymph nodes, bones, lungs, and the inferior vena cava extending into the right atrium. Hepatitis B and C infection were not seen. The available curative therapeutic modalities were minimal.
Conclusions:A marked male dominance was seen. Alcohol etiology was the dominant cause. Hepatoma may be the first presentation in undiagnosed liver disease. In all patients the diagnosis had been made at an advanced stage of the tumor thus resulting in a poor prognosis. We recommend that ultrasound scanning of the abdomen and alpha-feto protein estimation to be done at every six months interval in chronic liver disease patients.
