The Management of Hepatocellular Carcinoma at the Kara Teaching Hospital (Togo)

Objective: To describe the epidemiological, diagnostic, therapeutic and evolutionary aspects of hepatocellular carcinoma at CHU Kara. Method: This is a retrospective study conducted over a period of 3 years in the Department of General Surgery and Hepato-Gastroenterology of CHU-Kara (Togo). Were included in our study all patients, aged over 15 years old hospitalized for hepatocellular carcinoma. Results: We recorded 98 cases out of 7237 hospitalized patients, i.e. a frequency of 1.4%. The patients were consisted of 65 men and 33 women with a sex ratio (F/M) of 0.5. The average age was 49 years old. Clinically, painful hepatomegaly was found in all cases; abdominal pain in all cases, poor general condition in 86 patients; collateral venous circulation in 3 cases. Alpha-fetoprotein (AFP) was above 400 ng/ml in all patients. Abdominal imaging revealed diffuse liver involvement in 85 patients (86.7%), a localized nodular appearance in 13 cases (13.3%).All these patients had received symptomatic treatment combining analgesics and antispasmodics. The mortality rate was 97.9% within 12 months. Conclusion: Hepatocellular carcinoma remains a serious condition and its diagnosis is often difficult. It poses a real problem of care in our developing countries.