Prevalence of hepatocellular carcinoma in cirrhotic patients of Northern Sindh attending liver clinics at Ghulam Mohammad Mahar Medical College Hospitals Sukkur and Khairpur

Despite bearing the main burden of hepatocellular carcinoma,prospective studies from developing countries particularly pakistan are lacking. this prospective observational study was designed to estimate the prevalence of hcc among northern sindh patients with hepatic cirrhosis. objective: to assess the prevalence of hepatocellular carcinoma in cirrhotic patients of northern sindh attending liver clinics at ghulam mohammad mahar medical college hospitals sukkur and khairpur study design: prospective observational study place & duration of study: liver clinic ghulam mohammad mahar medical college hospitals sukkur and khairpur,between april 2008 and november 2010 methodology: between april 2008 and november 2010,we enrolled 301 patients with liver cirrhosis. patients found to be free of hepatocellular carcinoma (hcc) using baseline abdominal ultrasound,computed tomography (ct) scan of abdomen in selected cases and serum alphafetoprotein (afp) levels. patients were followed up prospectively for detection of hcc using ultrasound and afp every 6 months,liver biopsy and ct scan of abdomen in selected cases when required. results: among the 194 patients (mean age [sd] 45.1±13.1 years; male: female 6.1:1.0) followed up,154 had child's a and 40 had child's b disease. the causes of cirrhosis were: hepatitis b in 71 (36.6%),hepatitis c in 54 (27.8%),dual infection with hepatitis b and c in 12 (6.2%) and others including autoimmune,alcoholic and cryptogenic cirrhosis in 57 (29.4%) cases. during a cumulative follow up period of 563.4 person-years,9 cases of hcc were detected,with an incidence rate of 1.60 per 100 person-years. conclusion: in our study,the prevalence of hcc among patients with liver cirrhosis was intermediate,being lower than that in japan but higher than that reported from europe.