BACKGROUND Hepatocellular carcinoma (HCC) is a lethal malignancy which mostly develops in patients with cirrhosis. It is usually diagnosed late in the course of the illness and the median survival following diagnosis ranges between 6 - 20 months. India lacks data on management strategies and their efficacy. In the absence of data on treatment protocols and its adequacy; we evaluated our own centre data for a period of 1 year to get the estimate of incidence, aetiology, treatment adequacy and response to treatment. Barcelona Clinic Liver Cancer (BCLC) prognostic staging classification comprising five stages is used for prognostication, which is based on the extent of the primary lesion, performance status, vascular invasion and extrahepatic spread. Surgical therapies including resection and transplantation are feasible in early stages (BCLC stage 0 and stage A). Trans arterial chemoembolisation is recommended in intermediate stage (BCLC stage B) while systemic therapies are recommended in advanced stage (BCLC stage C). Best supportive care is recommended in terminal stage (BCLC stage D). This study has included BCLC staging for staging classification and patients were assessed for adequacy of management. METHODS This study was done as a retrospective hospital based observational study. All HCC patients presenting to Mahatma Gandhi Hospital attached to Dr. Sampurnanand Medical College, Jodhpur, Western Rajasthan from January to December 2014 were included. HCC was diagnosed based on European Association for the study of the Liver–European Organisation for Research and Treatment of Cancer (EASL–EORTC) clinical practice guidelines 2011. Patients were classified according to Barcelona Clinic Liver Cancer staging and management given was recorded. RESULTS Thirty-two patients who were diagnosed with HCC between January to December 2014 were included in the study. In three fourths of the patients (24) HCC was diagnosed based on typical findings on dynamic imaging studies (triple phase contrast enhanced CT-computed tomography abdomen and / or MRI- magnetic resonance imaging abdomen). Liver biopsy was needed in one fourth of the patients. Majority of the patients (87.5 %) had cirrhosis of the liver at the time of diagnosis of HCC. Some of these patients [5 (17.8 %)] were known cirrhotic patients. CONCLUSIONS Hepatitis B was the most common aetiology of HCC as mentioned previously in other studies, which is vaccine preventable. HCC is rarely diagnosed at an early stage in developing countries. Various treatment modalities are available which depend on the stage, local expertise and affordability. If the surveillance recommendations are strictly adhered,HCC can be diagnosed at an early stage. Affordability and compliance will remain issues in HCC management in our country increasing the socio-economic burden on the society. KEY WORDS Hepatocellular Carcinoma (HCC), BCLC Staging, Survival
IDDF2018-ABS-0195 Reduced muscle (RADIO) density and barcelona clinic liver cancer (BCLC) staging are independently survival prognostic of indonesia hepatocellular carcinoma (HCC) patients
