Hepatocellular carcinoma: Risk factors, pattern of presentation and outcome in a tertiary health facility

Akande Oladimeji Ajayi^1*, Ebenezer Adekunle Ajayi² and Oluwole Akinwumi Komolafe³

¹Department of Medicine, Federal Medical Centre, PMB 201, Ido-Ekiti, Nigeria.

²Department of Medicine, Federal Medical Centre,PMB 201, Ido-Ekiti, Nigeria.

³Department of Histopathology, Ladoke Akintola University Teaching Hospital

Osogbo, Nigeria.

*Corresponding author. E-mail:  dejiajayi2@yahoo.co.uk.  Tel: +234-803-447-6437.

Accepted 15 January 2009

   Abstract

Hepatocellular carcinoma is the fifth most common cancer in the world. Its incidence is increasing worldwide ranging between 3 and 9% annually.  The aim of this study was to see the pattern of clinical presentation, identify the possible risk factors and the clinical outcome among HCC patients presenting at our health facility. The case records of all patients with histopathological diagnosis of HCC within the study period June 2003-May 2008 were scrutinized. Demographic, clinical presentation, investigations, risk factors and outcome data were extracted. Data analysis was done using the SPSS computer soft ware. Logistic regression model was fitted to identify the impact of the various risk factors on HCC. A total number of 53 patients with histopathological diagnosis of HCC were registered. Their ages ranged from 35 to 73 and mean age of 50±21.8 years. Thirty seven (69.8%) were males while sixteen (30.2%) were females giving M: F ratio of 2.31:1. The left lobe was affected in 15.1% (8), right lobe in 22.6% (12) and both lobes in 62.3% (33). 54.7% tested positive for HBsAg, 3.8% were HCV-Ab positive. All the patients in this study presented at an advanced stage of the disease. Aflatoxin exposure, though not proven, because no test was done to incriminate it, was highly suspected and could be a major risk factor in this study; hence efforts need to be doubled up as regards effective awareness campaigns, general health /social education and food perseveration methods.

Key words: Hepatocellular carcinoma, aflatoxin, hepatitis B and C.