Hepatocellular carcinoma in Yemeni patients: a single centre experience over an 8-year period

Ak, Salem; Abdulrab, Amin; Alfakeh, Y; Aown, A.M.A. Al

doi:10.26719/2012.18.7.693

Cited by 11 publications

(16 citation statements)

References 25 publications

(24 reference statements)

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“…The major risk factors for developing hepatocellular carcinoma vary by region and degree of national development [26,27]. In the present study, HBV infection was the most common etiological factor in our environment as more than 65% of patients tested positive for HBsAg, which is consistent with the findings of other studies [2,3,11-13,18,26,27].…”

Section: Discussionsupporting

confidence: 92%

Hepatocellular carcinoma: clinicopathological profile and challenges of management in a resource-limited setting

et al. 2014

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BackgroundHepatocellular carcinoma is one of the most common cancers worldwide and its incidence is reported to be increasing in resource-limited countries. There is a paucity of published data regarding hepatocellular carcinoma in Tanzania, and the study area in particular. This study describes the clinicopathological profile of hepatocellular carcinoma in our local setting and highlights the challenging problems in the management of this disease.MethodsThis was a retrospective study of histopathologically confirmed cases of hepatocellular carcinoma seen at Bugando Medical Center between March 2009 and February 2013.ResultsA total of 142 patients (M: F = 2.2: 1) were studied representing 4.6% of all malignancies. The median age of patients was 45 years. Hepatitis B virus infection (66.2%) and heavy alcohol consumption (60.6%) were the most frequently identified risk factors for hepatocellular carcinoma. The majority of patients (88.0%) presented late with advanced stages. HBsAg was positive in 66.2% of the patients and Hepatitis C Virus antibody in 16.9%. Thirteen (9.2%) patients tested positive for HIV infection. Most patients (52.8%) had both right and left lobe involvement. The trabecular pattern (47.9%) was the most frequent histopathological type. None of patients had curative therapy because of the advanced nature of the disease. Coagulopathy (45.7%) was the most common complications. The overall mortality rate was 46.5% and it was significantly associated with comorbidity, HIV positivity, CD4+ count <200 cells/μl, high histological grade, advanced stage of the tumor, presence of distant metastases at the time of diagnosis, and associated complications (P < 0.001). The overall median duration of hospital stay was 14 days. The majority of patients (71.1%) were lost to follow-up at the end of the follow-up period.ConclusionsHepatocellular carcinoma patients in this region are relatively young at diagnosis and the majority of them present late with an advanced stage and high rate of distant metastasis. Lack of awareness of the disease, poor accessibility to healthcare facilities, and lack of screening programs in this region may contribute to advanced disease at the time of diagnosis. There is a need for early detection, adequate treatment, and proper follow-up to improve treatment outcome.

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Section: Discussionsupporting

confidence: 92%

Hepatocellular carcinoma: clinicopathological profile and challenges of management in a resource-limited setting

et al. 2014

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“…In our study, the morphological pattern of HCC at the time of diagnosis was unifocal in almost half of the cases, in keeping with other retrospective studies [ 24 , 29 , 41 ], but the contrary was true in the recent report from regional study [ 11 , 22 , 23 , 40 ].…”

Section: Discussionsupporting

confidence: 89%

“…The clinical presentation of HCC in our patients was not different from those in other studies [ 23 , 40 ], with abdominal pain and abdominal distension being the commonest symptoms. This presentation generally reflects the problem of late presentation.…”

Section: Discussioncontrasting

confidence: 61%

Clinical Presentation, Risk Factors, and Treatment Modalities of Hepatocellular Carcinoma: A Single Tertiary Care Center Experience

Aljumah

Kuriry

AlZunaitan

et al. 2016

Gastroenterology Research and Practice

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Objective. To investigate the risk factors, clinical characteristics, treatment modalities, and outcomes in Saudi patients with HCC and propose points for early detection of the disease. Methods. Patients were stratified according to underlying risk factors for the development of HCC. Barcelona Clinic Liver Cancer (BCLC) was used for cancer staging. Treatment was classified into surgical resection/liver transplantation; locoregional ablation therapy; transarterial embolization; systemic chemotherapy; and best supportive care. Results. A total of 235 patients were included. Males had higher tumor size and incidence of portal vein thrombosis. Viral hepatitis was a risk factor in 75.7%. The most common BCLC stages were B (34.5%) and A (33.6%), and the most common radiological presentation was a single nodule of less than 5 cm. Metastases were present in 13.2%. Overall, 77 patients (32.8%) underwent a potentially curative treatment as the initial therapy. The most commonly utilized treatment modality was chemoembolization with 113 sessions in 71 patients. The overall median survival was 15.97 ± 27.18 months. Conclusion. HCC in Saudi Arabia is associated with high prevalence of HCV. Potentially curative therapies were underutilized in our patients. Cancer stage BCLC-B was the most frequent (34.5%) followed by BCLC-A (33.6%). The overall median survival was shorter than other studies.

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“…In special clinical populations, overall high HCV prevalence was observed in the range of 6.4%–38.2% (n = 13 and median = 17.9%) [ 68 , 70 , 73 – 82 ] ( Table 2 ). The highest prevalence estimates were reported in patients with acute and chronic hepatitis at 37.1% [ 76 ] and in patients with HCC at 38.2% [ 79 ].…”

Section: Resultsmentioning

confidence: 99%

“…is similar to ours (2.2% vs. 1.9%, respectively), however, Gower et al . estimate was based on a single study, whereas ours was based on 24 studies [ 68 , 70 , 73 , 76 , 79 , 80 , 83 – 93 ]. The expanded search in our review has allowed us to identify HCV measures published in non-indexed journals and country-level reports.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis C Virus Epidemiology in Djibouti, Somalia, Sudan, and Yemen: Systematic Review and Meta-Analysis

2016

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ObjectivesTo characterize hepatitis C virus (HCV) epidemiology and assess country-specific population-level HCV prevalence in four countries in the Middle East and North Africa (MENA) region: Djibouti, Somalia, Sudan, and Yemen.MethodsReports of HCV prevalence were systematically reviewed as per PRISMA guidelines. Pooled HCV prevalence estimates in different risk populations were conducted when the number of measures per risk category was at least five.ResultsWe identified 101 prevalence estimates. Pooled HCV antibody prevalence in the general population in Somalia, Sudan and Yemen was 0.9% (95% confidence interval [95%CI]: 0.3%–1.9%), 1.0% (95%CI: 0.3%–1.9%) and 1.9% (95%CI: 1.4%–2.6%), respectively. The only general population study from Djibouti reported a prevalence of 0.3% (CI: 0.2%–0.4%) in blood donors. In high-risk populations (e.g., haemodialysis and haemophilia patients), pooled HCV prevalence was 17.3% (95%CI: 8.6%–28.2%) in Sudan. In Yemen, three studies of haemodialysis patients reported HCV prevalence between 40.0%-62.7%. In intermediate-risk populations (e.g.. healthcare workers, in patients and men who have sex with men), pooled HCV prevalence was 1.7% (95%CI: 0.0%–4.9%) in Somalia and 0.6% (95%CI: 0.4%–0.8%) in Sudan.ConclusionNational HCV prevalence in Yemen appears to be higher than in Djibouti, Somalia, and Sudan as well as most other MENA countries; but otherwise prevalence levels in this subregion are comparable to global levels. The high HCV prevalence in patients who have undergone clinical care appears to reflect ongoing transmission in clinical settings. HCV prevalence in people who inject drugs remains unknown.

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Hepatocellular carcinoma in Yemeni patients: a single centre experience over an 8-year period

Cited by 11 publications

References 25 publications

Hepatocellular carcinoma: clinicopathological profile and challenges of management in a resource-limited setting

Hepatocellular carcinoma: clinicopathological profile and challenges of management in a resource-limited setting

Clinical Presentation, Risk Factors, and Treatment Modalities of Hepatocellular Carcinoma: A Single Tertiary Care Center Experience

Hepatitis C Virus Epidemiology in Djibouti, Somalia, Sudan, and Yemen: Systematic Review and Meta-Analysis

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