Hepatocellular carcinoma in a low-incidence region. Surgical perspectives

Abstract

Background/aims: To study the characteristics and outcome of patients with hepatocellular carcinoma in a low-incidence region.

Methods: 98 patients with hepatocellular carcinoma who had been referred to the Surgical Department, National Hospital, Oslo, between 1981 and 1999 were studied retrospectively. Tumour size, prevalence of cirrhosis, serum alpha-fetoprotein concentration, rate of resection, type of resection and survival were analysed.

Results: 19% (19/98) of the patients had cirrhosis of varying aetiology. Median tumour size was 10 cm. alpha-Fetoprotein was normal in 46% of the patients. Hepatic resection was performed in 30 (31%) patients and 77% of the resections were major (more than 2 segments). Abdominal exploration was done in 33 patients and liver transplantation in 6 patients. No surgical intervention was made in 31 patients. Five-year actuarial survival in resected patients was 24%. Median survival of non-resected patients was 3.3 months.

Conclusion: The patient characteristics in this study differ from patient cohorts with hepatocellular carcinoma in other geographical areas. The main differences are large tumour size, low prevalence of the disease, and diverse aetiology of cirrhosis.