SOCIO - DEMOGRAPHIC FACTORS RELATED TO ADVANCED HEPATOCELLULAR CARCINOMA: A SINGLE CENTRE RETROSPECTIVE STUDY

Aim : To evaluate the patients various socio - demographic and clinical factors related to advanced HCC at our HCC unit at Tanta university hospitals. Methods : This study was performed at HCC center of Tanta university hospital by retrospective evaluation of the various socio - demographic data (ag e, gender, residence, socioeconomic condition and habits), clinical presentation, underlying risk factors (CHC, CHB and un - specified), child’s classification and APRI scoring of liver fibrosis of all 690 HCC patients that were recorded at HCC database in t he period from January 2014 to December 2015. All patients were divided to two groups: Group 1 that included 250 patients with early HCC, their ages with mean ± standard deviation (SD) equal 54.8 ± 12.795, with male to female ratio 155/95. Group 2: It incl uded 440 patients with intermediate to advanced HCC, their ages with mean ± SD equal 57.05 ± 13.366, with male to female ratio 299/141. Diagnosis of HCC was based on 4 - phases multi - detector computed tomography (MDCT) and/or dynamic contrast enhanced MRI. Results : Our results revealed that, advanced HCC patients in group2 had significant higher age distribution, present significantly more in rural patients and present also significantly more in poor socioeconomic conditions than early HCC patients in group1 (P values 0.0309, 0.0455 and 0.0107 respectively). Advanced HCCs patients of group2 showed highly significance higher grade underlying liver fibrosis by APRI score and Child’s classification B or C significantly more than early HCC patients of group1 (P v alues <0.0001 for both). Male gender, smoking, BMI and DM non - significantly linked to advanced HCC patients of group2 (P values 0.0309, 0.0628, 0.6168 and 0.0969). The clinical presentations of early HCC patients in group1 were asymptomatic incidentally di scovered presentations significantly more than that of advanced HCC patients in group2 (P value < 0.0001). CHB and CHC were the most risk factors for both early and advanced HCCs (P value < 0.0033). Conclusion : Advanced HCCs are significantly related to po or socioeconomic status especially in rural areas that may lead to delayed diagnosis until HCCs become more advanced and symptomatic, at the same time, advanced HCCs are related to high grade liver fibrosis and more advanced liver disease. From these concl usions we should recommend regular screening programs for early discovering of HCCs especially in rural areas with poor socioeconomic status especially for older patients with high grade liver fibrosis and Child’s B or Child’s C.