The Clinical Profile of Hepatocellular Carcinoma Patients at the Philippine General Hospital

Abstract

Objective: To describe the clinical characteristics of patients diagnosed with hepatocellular cancer admitted at the Philippine General Hospital from January 2001 to December 2006 Background: Hepatocellular carcinoma (HCC) is the third leading site of cancer in the Philippines. Although risk factors for HCC are already established, significance of risk factors may vary among regions. Diabetes has also not been examined as a risk factor among Filipinos. Methodology: This is a descriptive study with data collection done through chart review. All charts with the diagnosis of hepatocellular carcinoma admitted from 2001 to 2006 were retrieved from the Medical Records Section. Participants included all adult hepatocellular carcinoma patients, diagnosed with HCC either by: (1) biopsy or (2) mass > 2cm and elevated ?-fetoprotein >200. Demographic data, risk factors, and laboratory exams were collated. Descriptive statistics were generated using SPSS 15.0. Results: Two hundred twenty two patients were included in the study. Males outnumbered females (3.5:1). Majority were older than 50 years old. The most common symptom is abdominal pain. Two thirds had a history of drinking alcohol. Almost half were smokers. Thirty eight patients (40.0%) had previous hepatitis B and 66 patients (52.3%) had chronic Hepatitis B. Only 3 (6.2%) patients had hepatitis C infection. Two thirds had no evidence of cirrhosis. Thirteen percent of the population had diabetes mellitus while 20% of the HBsAg-negative patients had diabetes mellitus. Eighty seven percent were in the advanced stage and 11.7% were terminal stage. Conclusion: The most common risk factors for HCC are still hepatitis B infection and alcohol drinking. Diabetes mellitus deserves to be investigated as an important contributing factor to the development of HCC, especially in HBsAg-negative patients. Most patients belonged to late stages of the disease but a selection bias is recognized. Our study indicates the need for screening patients at risk so early-stage disease can be detected. Keywords : Hepatocellular carcinoma, ?-fetoprotein, risk factors, hepatitis, cirrhosis