Evolution of hepatocellular carcinoma epidemiology in Côte d’Ivoire

Coulibaly, Judith Didi-Kouko; Yeboua, Mireille; Mbengue, Alphonsine Kouassi; Kouadio, E.; Kissi, Henriette Anzouan-Kacou; Binan, Allah Yves-Omer; Kouacou, Marie-Jeanne Lohoues; Attia, Alain; Yao, Dowlo N'dri Athanase; Toutou, T.; Adoubi, Innocent; Pineau, Pascal

doi:10.1016/j.bulcan.2017.09.010

Cited by 3 publications

(2 citation statements)

References 19 publications

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“…Regarding the mean age (50.3 ± 15.7 years) of patients, it appears already different from that recently observed in West-African countries such as Ghana ( 17 ) and Senegal ( 18 ), which is respectively 45.2 and 47.4 years ( 17 . HCC onset in Gabon appears later than what is commonly reported in SSA countries but remains in keeping with descriptions made by Kew and Didi-Kouko et al ( 19 , 20 ). It is however much earlier than in European countries where it ranges between 63.3 and 70.9 years ( 21 ).…”

Section: Discussionsupporting

confidence: 89%

Drastic sex-dependent etiological distribution in severe liver diseases from Gabon

Moussavou-Boundzanga

Bignoumba²,

Mouinga‐Ondémé³

et al. 2022

Front. Oncol.

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Chronic liver diseases still represent a worrying public health issue in Sub-Saharan Africa. In this region, emphasis is generally made on hepatocellular carcinoma (HCC) albeit liver cirrhosis (LC) is also responsible for an important death toll. Very few studies have compared the presentation and etiologies of cancer and cirrhosis of the liver in Middle Africa. We conducted a comparative retrospective analysis of 74 and 134 cases of patients with HCC and LC treated in Libreville, Gabon. Viral or lifestyle risk factors, clinical symptoms, and biological features were compared. We observed that ages of diagnosis were 53.2 ± 15.7 years and 48.6 ± 18.6 years for HCC and LC with remarkably low M:F sex ratios (1.3-1.8). Ethanol consumption was highly prevalent in both disease types (65.0%-70.0%). Chronic viral infections with hepatitis B (HBV) or C (HCV) virus were also widespread with slight domination of the former in both diseases (43.4% vs. 34.3%, and 35.9% vs. 28.5%). Patients with HCC were presenting very late with a mean diameter of the main nodule of 84 ± 50 mm and a multifocal pattern in 72.7% of cases. HCC developed on a cirrhotic liver in 91.7% of cases. Serum AFP was frankly elevated (>400 ng/ml) in only 35.8% of HCC cases. The most striking feature of the HCC series was the contrasted contribution of distinct pathogenic etiologies involving sex, viral, metabolic, and toxic factors. A frequently dysmetabolic condition synergizing with hepatitis C (anti-HCV, 73.8% vs 22.7%, p < 0.0001) in females and a male cancer promoted by recreational toxicants and chronic hepatitis B (HBsAg, 83.5% vs 35.9%, p < 0.0001) were observed. Men with HCC were considerably younger than women (46.8 ± 14.5 years vs. 62.2 ± 12.2 years, p < 0.0001). Further studies are now warranted to identify routes of HCV transmission and if they are still fueling reservoirs of future patients. Public policies to prevent alcohol-related harm have also to be urgently implemented in Gabon.

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Section: Discussionsupporting

confidence: 89%

Drastic sex-dependent etiological distribution in severe liver diseases from Gabon

Moussavou-Boundzanga

Bignoumba²,

Mouinga‐Ondémé³

et al. 2022

Front. Oncol.

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“…It seems to be in keeping with values currently observed on the sub-continent where male predominance appears as less pronounced than in the past. As in most countries of the world, alcohol abuse was more often observed in Chadian men than women [19] [24] but according to patient self-reporting, its importance remains marginal in Chad (5.9%). This temperance is most probably due to the influence of Islam, the religion of the majority of Chadian citizens.…”

Section: Discussionmentioning

confidence: 99%

Hepatocellular Carcinoma in Chad: A Retrospective Study of 219 Cases

Moussa,

Pineau,

Habkreo

et al. 2023

OJGas

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Background: Although hepatocellular carcinoma was historically considered an important scourge in Middle Africa, there is no publication describing this disease in Chad. Methods: We conducted a retrospective analysis of 219 patients with hepatocellular carcinoma (HCC) attending care at the University Reference Hospital of Ndjamena between 2007 and 2016. Results: This series of HCC was characterized by a male predominance (M:F = 2.4) with a mean tumor onset at the end of the fifth decade of life (49.9 ± 14.7 years). Tumors appear on a cirrhotic liver in 70% of cases and were already multifocal at diagnosis in two thirds of the patients. Alpha-fetoprotein was above the physiological threshold (10 ng/mL) in 73.4% of cases measured and above the so-called diagnostic level (400 ng/mL) in 53.4% of patients. The principal risk factor was chronic infection with hepatitis B virus, detected in 52.6% of cases. Patients seropositive for hepatitis C virus were infrequent (8.6%) and heavy alcohol intake was even less prevalent (5.9%). Remarkably, a very large subset of patients did not present any infectious or lifestyle risk factor (43.4%). Mean AFP values or fibrosis assessment scores are usually lower in these patients than in HBV-infected ones. Conclusions: The etiological spectrum of HCC is far from being fully established in Chad. Further epidemiological research is warranted to identify risk factors involved in a large proportion of cases. Exposure to aflatoxin B1 and dysmetabolic conditions affecting the liver have to be investigated as priority.

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Hepatocellular carcinoma in Senegal: epidemiological, clinical and etiological aspects about 229 cases at Hopital Principal de Dakar

Diallo¹,

Ndiaye²,

Touré³

et al. 2021

Pan Afr Med J

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Hepatocellular carcinoma (HCC) is a major public health problem in Senegal, and the third most common cancer in terms of incidence. However, there are no recent data on the characteristics of this pathology in our country. The aim was to describe the epidemiological, clinical, aetiological and therapeutic aspects of HCC at Hôpital Principal de Dakar, Senegal. We did a descriptive retrospective study, including patients hospitalized from January 2012 to December 2017. We included 229 patients. The mean age was 47.4 years (21 - 88 years), and 77 patients (33.6%) were under 40 years of age. The sex ratio was 6.6. Twelve patients (5.2%) had a family history of 1 st degree cirrhosis or HCC. Ten patients (4.4%) were previously treated with nucleotide analogues. The most common clinical sign at diagnosis was abdominal pain (91.7%). Alpha-fetoprotein level was normal in 12.2% of patients, and greater than 400 ng/ml in 68.1% of cases. Abdominal ultrasound found nodular HCC in 122 patients (68.2%), infiltrative HCC in 19 patients (10.6%), and was normal in 38 cases (21.2%). Subjacent cirrhosis was detected in 71.3% of cases. Abdominal computed tomography (CT) scan showed compatible HCC lesions in 88.8% of cases. A histological diagnosis was obtained in 2 patients (0.9%). The most common etiological factor was hepatitis B virus (69.4%), characterized mostly by a younger age (p = 0.001). In 20.9% of cases, no aetiology was found. An advanced or terminal stage (BCLC C/D) was found in 217 cases (94.8%). The treatment was curative in 12 patients (5.2%), and palliative in 7 cases (3.1%). The evolution at one year was favourable in 6 patients (2.6%). Hepatocellular carcinoma (HCC) is a disease that mainly affects young male adults in Senegal. The main aetiological factor remains HBV infection. The diagnosis is made at an advanced stage and the prognosis very bad.

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Evolution of hepatocellular carcinoma epidemiology in Côte d’Ivoire

Cited by 3 publications

References 19 publications

Drastic sex-dependent etiological distribution in severe liver diseases from Gabon

Drastic sex-dependent etiological distribution in severe liver diseases from Gabon

Hepatocellular Carcinoma in Chad: A Retrospective Study of 219 Cases

Hepatocellular carcinoma in Senegal: epidemiological, clinical and etiological aspects about 229 cases at Hopital Principal de Dakar

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