P- 23 HEPATOCELLULAR CARCINOMA IN CENTRAL AMERICA: EPIDEMIOLOGY OF A COSTA RICAN COHORT

Introduction and Objectives

Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-related mortality worldwide and a major problem in Latin America. It is characterized by significant epidemiological heterogeneity, but most data come from resource-rich countries. This is the largest cohort to date reporting HCC characteristics and outcomes in Central America.

Materials and Methods

Retrospective analysis of a cohort of HCC diagnosed radiographically or histologically and analysis of daily practice from a specialized Costa Rican center.

Results

From 10/2018 to 03/2023, 200 patients with HCC were evaluated. The median age at diagnosis was 67 years and 61% were men. The most common etiologies were NAFLD, alcohol, viral hepatitis, and autoimmune hepatitis (63, 22, 5 HBV, 4 HCV, and 3%, respectively), 67% had arterial hypertension, and 60% DM2. Diagnosis was 55% incidental (53% ultrasonography and 2% CT/MRI), 45% during surveillance (40% US, 3.5% CT/MRI and 1.5% AFP increase with negative US) and 42% had a significant elevation of AFP (20 ug/L). Child-Pugh Score was 54, 33 and 6% for A, B and C respectively and 7% were non-cirrhotic (71% NAFLD). The modified BCLC staging system for HCC in cirrhotic liver was 3, 46, 17, 22, and 12% for stage 0, A, B, C, and D, respectively. Being diagnosed during surveillance was significantly associated with a curable BCLC stage (0 or A) (p=0.003) but not with better overall survival (p=0.18).

Conclusions

This study represents the largest cohort to date reporting HCC characteristics in Central America. Most HCCs are diagnosed incidentally and in a non-curable stage. Health policies should be directed based on the epidemiological factors identified in order to reduce the mortality of these patients.