Clinicopathological Features and Survival of Patients with Hepatocellular Carcinoma in Ethiopia: A Multicenter Study

Author:

Abza Getahun BefirduORCID,Ahmed Jemal HussienORCID,Yesufe Abdu AdemORCID,Seife Edom,Erkie Mengistu,Spriet Isabel,Chelkeba Legese,Annaert PieterORCID

Abstract

(1) Background: Hepatocellular carcinoma (HCC) is one of the deadliest cancers globally, killing over 700,000 people each year. Despite the rising incidence and mortality rates of HCC in Ethiopia, only few single-centered studies have been conducted; therefore, we aimed to explore the clinicopathological characteristics and survival of patients with HCC in multicenter settings. (2) Methods: We conducted a retrospective analysis of 369 patients with confirmed HCC diagnosed between 2016 and 2021. The survival of patients weas determined using the Kaplan–Meier method, and hazard ratios of the prognostic factors were estimated in Cox proportional hazard models. (3) Results: Majority patients were male (67%) and had a mean age of 52.0 ± 15.6 years. The majority of patients (87%) had a large tumor size (>5 cm) at diagnosis and presented with an advanced-stage condition. Cirrhosis (58%) and viral hepatitis (46.5%) were the main risk factors associated with HCC. The median overall survival was 141 days (95% CI: 117–165). Patients who took antivirals for HBV had a higher survival benefit compared to the untreated group (469 vs. 104 days; p < 0.001). The risk of death was 12 times higher in patients with Barcelona Clinic Liver Cancer-D (BCLC-D) terminal stage HCC compared to patients with an early stage (BCLC-A) HCC. The stage of HCC and treatment against HBV are the most significant survival predictors. (4) Conclusions: The overall survival of HCC patients in Ethiopia is poor. Cirrhosis and viral hepatitis are the primary risk factors linked with HCC. Patients who received antiviral therapy for HBV had a better survival outcome.

Funder

KU Leuven Global Minds Doctoral Scholarships Programme

Publisher

MDPI AG

Subject

Cancer Research,Oncology

Reference38 articles.

1. Epidemiology of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma;Massarweh;Cancer Control,2017

2. Hepatocellular Carcinoma in Sub-Saharan Africa;Sewram;JCO Glob. Oncol.,2021

3. Hepatocellular Carcinoma: Epidemiology and Molecular Carcinogenesis;Rudolph;Gastroenterology,2007

4. Epidemiology and Aetiology of Hepatocellular Carcinoma in Sub-Saharan Africa;Mak;Hepatoma Res.,2021

5. (2022, December 09). Ministry of Health-Ethiopia National Strategic Plan for Prevention and Control of Viral Hepatitis in Ethiopia, 2021–2025. Available online: https://www.globalhep.org/sites/default/files/content/resource/files/2022-05/Final Hep NSP 2021-2025 Aug 27.pdf.

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