Premium
Liver cancer in M alaysia: Epidemiology and clinical presentation in a multiracial A sian population
Author(s) -
Goh KheanLee,
Razlan Hamizah,
Hartono Juanda Leo,
Qua ChoonSeng,
Yoong BoonKoon,
Koh PengSoon,
Abdullah Basri Johan Jeet
Publication year - 2015
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12223
Subject(s) - medicine , stage (stratigraphy) , hepatocellular carcinoma , epidemiology , gastroenterology , population , cancer , liver cancer , hepatitis b , surgery , paleontology , environmental health , biology
Objective Hepatocellular carcinoma ( HCC ) is an important cancer in M alaysia. This study aimed to determine the epidemiological characteristics and clinical presentations of patients in a multiracial population consisting of three major A sian races: M alays, C hinese and I ndians. Methods Consecutive patients with HCC were prospectively studied from 2006 to 2009. HCC was diagnosed principally on multiphasic computed tomography and magnetic resonance imaging scans of the liver. The tumor was staged according to the B arcelona C linic L iver C ancer ( BCLC ) classification. Results Altogether, 348 patients were diagnosed with HCC . There were 239 (68.7%) Chinese patients, 71 (20.4%) Malays and 38 (10.9%) Indians, with the median age of 62.5 years and the male to female ratio of 3.4:1. The predominant etiology in M alay and C hinese patients was hepatitis B virus infection (>60%) and in I ndian patients was alcohol intake (26.3%) and cryptogenic cause (29.0%). Hepatitis C was seen in 18.3% of Malays, but less than 10% in C hinese and I ndians. BCLC staging was: Stage A, 120 (34.5%); Stage B, 75 (21.6%); Stage C, 84 (24.1%); and Stage D, 69 (19.8%). A larger proportion of I ndian than Chinese and Malays patients (44.7%) presented with stage D disease. Portal vein invasion was noted in 124 patients (35.6%) and extrahepatic metastases in 68 (19.5%). Surgical resection and radiofrequency ablation with curative intent was carried out in >90% of stage A patients and transarterial chemoembolization in 49.3% and 21.4% of stages B and C patients, respectively. Conclusions HCC is most common among C hinese, followed by M alays and Indians in Malaysia. The etiology of HCC shows a peculiar racial pattern.