Hepatocellular Carcinoma in Oman: An analysis of 284 cases

Abstract

Objectives: Hepatocellular carcinoma (HCC) is the most common type of primary liver tumour worldwide and is increasing in incidence. This study aimed to describe the clinical characteristics of HCC among Omani patients, along with its major risk factors, outcomes and the role of surveillance. Methods: This retrospective case-series study was conducted between January 2008 and December 2015 at the three main tertiary care hospitals in Oman. All adult Omani patients diagnosed with HCC and visited these hospitals during the study period were included. Relevant data were collected from the patients’ electronic medical records. Results: A total of 284 HCC patients were included in the analysis. The mean age was 61.02 ± 11.41 years and 67.6% were male. The majority had liver cirrhosis (79.9%), with the most common aetiologies being chronic hepatitis C (46.5%) and B (43.2%). Only 13.7% of cases were detected by the HCC surveillance programme. Approximately half of the patients (48.5%) had a single liver lesion and 31.9% had a liver tumour of >5 cm in size. Approximately half (49.2%) had alpha-fetoprotein levels of ≥200 ng/mL. The majority (72.5%) were diagnosed using multiphase computed tomography alone. Less than half of the patients (48.9%) were offered one or more HCC treatment modalities. Conclusion: The majority of Omani HCC patients were male and had cirrhosis due to viral hepatitis. In addition, few patients were identified by the national surveillance programme and presented with advanced disease precluding therapeutic or even palliative treatment.Keywords: Hepatocellular Carcinoma; Liver Cirrhosis; Human Viral Hepatitis; Public Health Surveillance; Early Detection of Cancer; Alpha-Fetoprotein; Oman.

The Troubling Link Between Non-alcoholic Fatty Liver Disease (NAFLD) and Extrahepatic Cancers (EHC)

“…Among the 195 countries studied in this report, the highest growth rate of incident cases was found in the Gulf Cooperation Council countries with UAE leading with a whopping 1,119% increase, followed by Qatar (776%) and Oman (540.67%) [20]. Surprisingly, in a study of HCC diagnosed from Oman between 2008 and 2015, of 284 patients, only two of 227 patients with cirrhosis (0.9%) were reported to have a cryptogenic etiology [21] (potentially due to NASH), while alcoholic cirrhosis was much higher at 9.5%. This highlights a vexing problem; overlapping conditions such as viral hepatitis in the case of NASH will lead to underestimation of NASH as a cause of cirrhosis and under-recognition of NASH as a cause of HCC.…”

“…Surprisingly, in a study of HCC diagnosed from Oman between 2008 and 2015, of 284 patients, only two of 227 patients with cirrhosis (0.9%) were reported to have a cryptogenic etiology [ 21 ] (potentially due to NASH), while alcoholic cirrhosis was much higher at 9.5%. This highlights a vexing problem; overlapping conditions such as viral hepatitis in the case of NASH will lead to underestimation of NASH as a cause of cirrhosis and under-recognition of NASH as a cause of HCC.…”

Current Status of Management of Hepatocellular Carcinoma in The Gulf Region: Challenges and Recommendations

“…In a retrospective case-series study conducted between January 2008 and December 2015 at the three main tertiary care hospitals in Oman, the majority of patients with HCC were male with liver cirrhosis due to viral hepatitis. Additionally, few patients presented with advanced disease, precluding therapeutic or even palliative treatment [ 31 ]. In 2019, a total of 68 cases of liver cancer were recorded in Oman, with 46 hospital deaths [ 30 ].…”

Liver diseases among Arab world, current state and unmet needs, a scoping review

“…There were two studies described the clinical characteristics among patients with HCC. One study from KSA (369), while the second study was from Oman (370).…”