Laura Ladrón de Guevara, Paulo Rojas-Macuil, Xochiquetzal Sánchez-Chávez, Alejandro Rossano-García, Ma. Teresa Gorraez-de-la-Mora, Guadalupe Cervantes-Sánchez, Julita Orozco-Vázquez, Mario Lemus- Velázquez, Leticia Rosas-Zúñiga, Aura Erazo-Valle, Mauricio Di-Silvio
Introduction. Hepatocellular carcinoma (HCC) has become a frequent type of cancer in Mexico. At the present time it represents the 19th cause of death in the population. Objective. To recognize the epidemiological profile and the treatment results in a cohort of federal employees with HCC. Material and methods. We analyzed 47 consecutive cases with HCC diagnosis from January 2004 till December 2007. Twenty four demographic data, tumor staging, clinical, and biochemical variables were analyzed to identify parameters predicting survival by computing Kaplan-Mier and Mantel-Cox survival curves. Results. Patient reference increased 5% each year. The mean age was 60.4 years, 63.8% female sex, and 72.3% had cirrhosis, 44.7% had Hepatitis C infection. Most patients presented with advanced disease: 55.3% were AJCC stage 3 and 21.3% stage 4, 51.1% were BCLC class D. Mean tumor size was 8.09 cm. Median survival time from diagnosis was 122 days. Patients that did not receive treatment had a median survival of 70 days; the longest survival of patients was of those that received transarterial chemoembolization with a median of 707 days, followed by surgery with 683 days. Univariate analysis showed survival was associated to MELD score, AJCC and BCLC staging, creatinine level and ascites. Multivariate analysis showed tumor differentiation, AJCC staging and the choice of treatment to be related to the risk of death. Conclusion. An increase in the referral of HCC was demonstrated. Most patients had cirrhosis and HCV infection. Due to advance disease staging, TACE was the treatment that offered longest survival.
Key words. Hepatocellular carcinoma, Cirrhosis, Hepatitis C, Survival, Epidemiology