Hepatocellular carcinoma in Sri Lanka - where do we stand?

Abstract

Hepato-cellular carcinoma (HCC) is the sixth commonest cancer and third in cancer-related mortality worldwide. There are no published reports on the pattern of HCC in Sri Lanka. North Colombo Liver Unit maintains a prospective database of 105 HCC patients from September 2011. HCC was diagnosed based on characteristic radiological appearance. Best form of treatment was decided by a multidisciplinary team (MDT). Median age at presentation 63 (12 - 79) years. 87% (n=93) males. 45% (n= 47) had alcohol consumption above safe limits .41% (n=53) had diabetes. Cirrhosis was present in 79% (n=83) .median Model for End Stage Liver Disease (MELD) score 12 (4-22); Childs- Pugh class A 45% (n=37), Childs- Pugh class B or C 55% (n=46)]. A biopsy was necessary in 7 (6.6%) while others were diagnosed on radiology .62.5% had AFP level above the reference range (> 10 ng/ml). 51(49%) had a single modality, 17 (16%) had combined treatment and the rest had no treatment. The overall mean survival was 15 months. Majority of HCCs in Sri Lanka were among males and is likely to be secondary to NASH related cirrhosis. Majority of the tumours were diagnosed at late stage.