A Comprehensive Overview of In-patients Treated for Hepatocellular Carcinoma at a Tertiary Care Facility in Tanzania

A. Mwanga, James Mwakipesile, Daniel William Kitua, Y. Ringo
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Abstract

Hepatocellular carcinoma (HCC) is one of the commonest causes of cancer-related morbidity and mortality worldwide. However, only a limited number of studies on HCC have been conducted in Tanzania. We therefore conducted a cross-sectional study among in-patients treated for HCC in a tertiary referral hospital located in Dar es Salaam, Tanzania, in order to provide a concise description of the clinical characteristics and treatment options offered in the study setting. We identified 36 in-patients treated for HCC over a 6-month data collection period. Seventy-seven percent (n = 28) of the participants were males and about two-thirds (61.2%) were aged between 40 and 60 years. Majority (44.4% [n = 16]) of the patients had Child-Pugh class B and an Eastern Cooperative Oncology Group (ECOG) performance status of 2 (33.3% [n = 12]). Patients with tumors >6.5 cm and multinodular tumors (>3 nodules) accounted for 69.4% (n = 25) and 55.6% (n = 20), respectively. Portal vascular invasion and extrahepatic metastasis were respectively present in 27.8% (n = 10) and 25% (n = 9) of the patients. Of the study participants, only two had early-stage disease as per the Barcelona Clinic Liver Cancer (BCLC) staging system, corresponding to the observed tumor resection rate of 5.6%. The most frequently reported inoperable factor among the study participants was an ECOG performance status > 0 (n = 30 [83.3%]). Findings thus reveal a high proportion of late-stage diseases among participants that could have resulted in the observed low tumor resection rate. Initiatives to facilitate identification of the disease at an early stage are therefore paramount in optimizing care.
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在坦桑尼亚三级医疗机构治疗肝细胞癌住院患者的全面概述
肝细胞癌(HCC)是世界范围内最常见的癌症相关发病和死亡原因之一。然而,在坦桑尼亚,关于HCC的研究数量有限。因此,我们对坦桑尼亚达累斯萨拉姆一家三级转诊医院治疗HCC的住院患者进行了一项横断面研究,以便对研究环境中提供的临床特征和治疗方案进行简要描述。我们在6个月的数据收集期内确定了36例接受HCC治疗的住院患者。77% (n = 28)的参与者是男性,约三分之二(61.2%)的年龄在40至60岁之间。大多数患者(44.4% [n = 16])为Child-Pugh B级,东部肿瘤合作组(ECOG)表现状态为2 (33.3% [n = 12])。肿瘤>6.5 cm和多结节(>3个结节)分别占69.4% (n = 25)和55.6% (n = 20)。27.8% (n = 10)的患者存在门静脉侵犯,25% (n = 9)的患者存在肝外转移。在研究参与者中,根据巴塞罗那临床肝癌(BCLC)分期系统,只有2人患有早期疾病,对应于观察到的肿瘤切除率为5.6%。研究参与者中最常报告的不手术因素是ECOG表现状态> 0 (n = 30[83.3%])。因此,研究结果显示,参与者中有很高比例的晚期疾病可能导致观察到的低肿瘤切除率。因此,促进在早期阶段识别疾病的举措对于优化护理至关重要。
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