Epidemiology and Survival of Hepatocellular Carcinoma in the Central Region of Thailand


Background: Hepatocellular carcinoma (HCC) is one of the most common cancers in men and the third mostcommon cancer in woman in Thailand. This retrospective study was designed to assess the prevalence, clinicalmanifestations, treatment outcomes and prognosis of HCC in the central region of Thailand. Materials and
Methods: The authors retrospectively reviewed all HCC patients aged more than 15 years old in Thammasatuniversity hospital (TUH) during the period from January 2007 to December 2012. Clinical information,biochemical tests and radiologic findings were collected from review of medical records.
Results: There were308 patients with HCC, which accounted for the prevalence of 5.19% of all cancers diagnosed in TUH duringthe study period. Of these, 125 (40.5%) had complete information retrievable from their medical records andmet the inclusion criteria, 99 (79.2%) were males. The mean age was 57.4 years. A quarter of HCC patients inthis study presented without any symptom before diagnosis. The common clinical presentations in the remainingpatients were hepatomegaly 64/125 (51.2%), abdominal pain 56/125 (44.8%) and ascites 16/125 (20.8%). Cirrhosiswas seen in almost all patients (92.8%). The most common causes of HCC in this study were chronic hepatitisB (49.6%) and C (19.2%). Based on Barcelona Clinic Liver Cancer staging, 75.4% presented at intermediateor late stage. Patients receiving curative therapy with either surgical treatment or radiofrequency ablation hadsignificantly longer survival time after the HCC diagnosis than the palliative therapy group (11.0 months vs 4.0months, p value= 0.004). The mean survival time after the HCC diagnosis was 10.5 months.
Conclusions: Thecommon causes of HCC in central region of Thailand were chronic hepatitis B and C. Surgical therapy or RFAseemed to provide better outcomes than other treatments but only in patients with early stage lesions. Most ofthe patients in this study presented with advanced diseases and had grave prognosis. Appropriate screeningpatients at risk for HCC might be an appropriate way to achieve early diagnosis and improve the treatmentoutcome.