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Scripta Scientifica Medica

Management of hepatocellular carcinoma: a study on 240 patients in a single referral center

Irina Ivanova Ivanova, Sonya Banova, Milko Mirchev, Iskren Kotzev, Alexander Zlatarov, Anton Tonev, Nikola Kolev, Svetomir Chakarov, Chavdar Bachvarov, Boyan Balev, Yana Bocheva, Maria Tzaneva


Introduction: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death globally. Our study aimed to provide an understanding of the risk factors, pattern and management of HCC in a real-life practice.

Materials and Methods: Two hundred and forty consecutive patients with HCC were evaluated for an 11-year period (from 2006 to 2016). During the last 5 years the patients were followed up prospectively from the time of the diagnosis to their death.

 Results: A hundred and seventy-two males and 68 females (mean age 66.4 ± 10.3 and 62.4 ± 9.5 years, respectively) were included in the observation. Hepatitis B virus (HBV) infection accounted for 40.4% and hepatitis C virus (HCV) infection - for 25.8% of the aetiology of liver disease. Cirrhosis is a baseline condition in 82%. HCC was found to be a first complication of liver disease in 2/3 of the studied patients. Using Barcelona Clinic Liver Cancer staging system HCC can be categorised as: stage 0 (n=3); stage A (n=32); stage B (n=52); stage C (n=75) and stage D (n=103). Therefore, the prevalence of very early and early HCC was 13%. Radical therapy (resection or ablation) was recommended in 28% of the patients. Importantly, 18 of 55 (32.7%) patients after surgical resection were followed for more than 3 years without tumour relapse. The median survival, based on the main treatment was: 36 months after surgical resection; 24 months after ablation; 10.5 months for patients on Sorafenib; 9.5 months after TACE and only 3 months for palliative care.

 Conclusion: Our study confirms the observed trends in underlying diseases, the heterogeneity of survival and underscores the need of early diagnosis of HCC.


Hepatocellular Carcinoma; Hepatitis B; Hepatitis C; Surveillance; Survival

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About The Authors

Irina Ivanova Ivanova
Clinic of Gastroenterology, St. Marina University Hospital

Sonya Banova
Clinic of Gastroenterology, St. Marina University Hospital

Milko Mirchev
Clinic of Gastroenterology, St. Marina University Hospital

Iskren Kotzev
Clinic of Gastroenterology, St. Marina University Hospital

Alexander Zlatarov
First Clinic of Surgery, St. Marina University Hospital

Anton Tonev
First Clinic of Surgery, St. Marina University Hospital

Nikola Kolev
First Clinic of Surgery, St. Marina University Hospital

Svetomir Chakarov
Clinic of Imaging Diagnostics, St. Marina University Hospital

Chavdar Bachvarov
Clinic of Imaging Diagnostics, St. Marina University Hospital

Boyan Balev
Clinic of Imaging Diagnostics, St. Marina University Hospital

Yana Bocheva
Clinical Laboratory, St. Marina University Hospital

Maria Tzaneva
Clinic of General and Clinical Pathology, St. Marina University Hospital

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