Walid Elmoghazy1, Khalid Ahmed2, Adarsh Vijay2, Yasser Kamel3, Ahmed Elaffandi4, Walid El-Ansari5, Rasul Kakil6, Hatem Khalaf2. 1. Department of Surgery, Hamad Medical Corporation, Doha, Qatar; Department of Surgery, Sohag University, Sohag, Egypt. Electronic address: moghazyw@gmail.com. 2. Department of Surgery, Hamad Medical Corporation, Doha, Qatar. 3. Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar. 4. Department of Surgery, Hamad Medical Corporation, Doha, Qatar; Department of Surgical Oncology, National Cancer Institute, Cairo University, Egypt. 5. Department of Surgery, Hamad Medical Corporation, Doha, Qatar; School of Health, University of Skövde, Skövde, Sweden. 6. National Center for Cancer Care and Research, Doha, Qatar.
Abstract
BACKGROUND AND STUDY AIMS: Hepatocellular carcinoma (HCC) with extrahepatic metastasis has been studied, however, data from the Middle East remain scarce. In this study, we assess epidemiology of HCC in Qatar, and identify predictors of the metastatic behaviour. PATIENTS AND METHODS: All newly-diagnosed HCC patients on top of liver cirrhosis between 2011 and 2015 were included in the study. RESULTS: A total of 180 patients met our inclusion criteria. The mean age was 58.8 ± 10.5 years with a mean follow-up of 1.0 ± 1.1 years. There were 150 male patients and HCV was the most common cause of liver cirrhosis 108 (60%), and 22 (12.2%) patients were classified as Child-Pugh class C. The overall survival of 51.1%, and 47 (26%) had at least one extrahepatic metastasis at the time of diagnosis. Single site metastasis was diagnosed in 10 patients, whereas 37 patients had multiple sites metastases. We compared patients who had metastases with patients who did not have metastasis at the time of diagnosis of HCC regarding several variables, and analysis revealed that tumour diameter larger than 5 cm (OR = 6.10, 95% CI = 1.85-20.12) (p = 0.003), and bilobar liver involvement (OR = 5.49, 95% CI = 1.10-27.30) (p = 0.037) were independent predictors of metastatic behaviour of HCC. CONCLUSION: The incidence of HCC is rising in our population, extrahepatic metastasis is no longer rare and tumours larger than 5 cm and bilobar involvement are determinants of the extrahepatic metastasis.
BACKGROUND AND STUDY AIMS: Hepatocellular carcinoma (HCC) with extrahepatic metastasis has been studied, however, data from the Middle East remain scarce. In this study, we assess epidemiology of HCC in Qatar, and identify predictors of the metastatic behaviour. PATIENTS AND METHODS: All newly-diagnosed HCC patients on top of liver cirrhosis between 2011 and 2015 were included in the study. RESULTS: A total of 180 patients met our inclusion criteria. The mean age was 58.8 ± 10.5 years with a mean follow-up of 1.0 ± 1.1 years. There were 150 male patients and HCV was the most common cause of liver cirrhosis 108 (60%), and 22 (12.2%) patients were classified as Child-Pugh class C. The overall survival of 51.1%, and 47 (26%) had at least one extrahepatic metastasis at the time of diagnosis. Single site metastasis was diagnosed in 10 patients, whereas 37 patients had multiple sites metastases. We compared patients who had metastases with patients who did not have metastasis at the time of diagnosis of HCC regarding several variables, and analysis revealed that tumour diameter larger than 5 cm (OR = 6.10, 95% CI = 1.85-20.12) (p = 0.003), and bilobar liver involvement (OR = 5.49, 95% CI = 1.10-27.30) (p = 0.037) were independent predictors of metastatic behaviour of HCC. CONCLUSION: The incidence of HCC is rising in our population, extrahepatic metastasis is no longer rare and tumours larger than 5 cm and bilobar involvement are determinants of the extrahepatic metastasis.