Page 335 - ebook HCC

GENEVA, SWITZERLANDA, SWITZERLAND
PROGRAMME
EASL
332 PROGRAMME AND ABSTRACTSAND ABSTRACTS GENEV EASL HCC SUMMITHCC SUMMIT 333
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333
FEBRUAR
FEBRUARY 13 - 16, 2014Y 13 - 16, 2014
Poster Board Number C91
CHALLENGES FACING BCLC THERAPEUTIC
ALGORITHM IN TREATMENT OF 1437 EGYPTIAN
HEPATOCELLULAR CARCINOMA PATIENTS

Ahmed El Dorry , Amr El Fouly , Ashraf El Breedy, Neveen Elfoly , Challenges facing treatment of HCC in Egypt are ignorance, poverty, lake of uniform
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Mohamed Salah , Mohamed S. Hassan , Mahmoud El Metenei , Mohamed K. Shaker standard health insurance, shortage of equipments, cadaveric transplantation and
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and Hepatoma Group - Ain Shams University Hospitals - Egypt surgical theaters that could cover demands all over the country; all these factors led to;
1 Intervention Radiology, Ain Shams University, Hepatology, Tropical Medicine, Egyptian Liver resection in 15%, Living Donor liver transplantation in 14%, and Sorafenib in 9%
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Atomic Energy Authority, Tropical Medicine, Liver Transplant Surgery, Ain Shams among each indicated HCC population. Meanwhile locoregional therapies cover 92.5%
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University, Cairo, Egypt of indicated heat ablation, and 81% of the indicated TACE. Locoregional therapy could
replace 76% of the indicated patients for either resection or transplantation, but treatment
Corresponding author’s e-mail: amrfouly@yahoo.com of BCLC-C is still challenging.
Conclusion: For socio-economic reasons, treatment of HCC is still challenging and
Introduction: Hepatitis C virus (HCV) is the main cause of liver cirrhosis in 15-18% of defective in respect to BCLC therapeutic algorithm among Egyptians, but fortunately
Egyptian population. The expected annual incidence of Hepatocellular Carcinoma (HCC) single or combined locoregional therapy could compensate the shortage especially in
is approximately 12000 new cases. A statistical model predicts to reach the peak of HCC surgical options.
related mortality by year 2040. HCC is ranked the 2 common malignancy in males.
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Aims: Our aim is to clarify at time of diagnosis, the indicated number of patients in each
Barcelona Clinic of Liver Cancer (BCLC) stage, meanwhile to focus on actual decisions
to highlight and realize the requirements and shortage in management of HCC in Egypt.
Methodology: 1437 Egyptian HCC patients diagnosed during between 2009 & 2012
classified with different staging systems especially Performance status, Child-Pugh
classification, BCLC staging looking for the proper decision making fitting each single
CLINICAL POSTER ABSTRACTS Results: HCV infection is considered the main etiology of liver cirrhosis in Egypt 93% CLINICAL POSTER ABSTRACTS
case.

(1232/1325). HBsAg is positive in 13.7% (103/751). Males have 6 folds higher risk of HCC
than females. The prevalence of HCC is more common during the 6 & 8 decades 77.4%.
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Half of patients (51%) have good Child A liver cirrhosis at time of diagnosis, while Child
B & C are 37% and 12% respectively. Decision making in respect to BCLC therapeutic
algorithm are; BCLC Stage (A=24%), (B=21%), (C=41%), and (D=14%). Thus, BCLC-A1
“Resection” is indicated in 4.7%(67), BCLC-A2 = “Local ablation” in 4.1%(59), BCLC-A3
& A4= “Orthotropic liver transplantation” in 15%(209), BCLC-B = “TACE” in 20.3%(290),
BCLC-C = “Sorafenib” in 40%(568) and finally BCLC-D = “Best supportive care” in
13%(187).