Comprasi̇on of epi̇demi̇ology,tumor characteri̇sti̇cs cli̇ni̇cal and vi̇rologi̇c parameters of pati̇ents di̇agnosed wi̇th hepatocellular carci̇noma from vari̇ous eti̇ologi̇es

ABSTRACT Introduction: In this study, we aim to evaluate the etiologic factors associated with Hepatocellular carcinoma and their role on the clinical outcome and prognosis of the disease. Method: 377 patients diagnosed with Hepatocelular carcinoma were analysed both retrospectively and prospectively. HCC was diagnosed based on radiologic, histologic, clinical and laboratory findings. Patients were randomized according to the etiologic factors. Results: Mean age in patients were 58.70±12.50 years. HCC were developed in elder age in HCV group (mean age: 65.42±10.05 years) (p=0.001), in contrast to HDV group (mean age : 53.39±10.75 years). 310 of patients were male (82%) and 67 of them were female. HCC occurs secondary to HBV in 57.8%, HDV in 15.6%, HCV in 8.2% and non-viral causes in 18.3% of all patients. Mean duration of infection in patients were 9.38±9.08 years and 23.6% of them were on antiviral therapy. Between groups, mean viral replication rate was found to be statistically higher in patients with HCC due to HCV (p=0.001). In many patients, HCC were developed secondary to cirrhosis. In all groups, serum AFP levels were high which is statistically most significant in hepatitis B virus group (p=0.008). Many patients were Child-Pugh B-C while at diagnosis and maximum tumor diameter was above 5 cm in all groups. Among all groups, no statistically significant difference in average survival rate were found. Conclusion: HCC which the most important risk factors are viral hepatitis, frequently occurs in patients with cirrhosis, so surveillance and follow-up of cirrhotic patients are crucial. In our region, old age and high stage of disease while at diagnosis still remain an important healthcare problem. That is why, in our country, we urgently need cancer surveillance programs as well as new diagnostic and therapeutic developments. Keywords: Hepatocellular carcinoma, hepatitis B virus, hepatitis C virus, hepatitis D virus, etiology, epidemiology