Abstract 190P
Background
The Ministry of Health and Population in Egypt via National Committee for Control of Viral Hepatitis launched a program for treatment of advanced hepatocellular carcinoma (HCC) that included systemic therapy and immunotherapy based on International and National guidelines.
Methods
This was a prospective observational study in which patients with advanced HCC suitable for systemic therapy were identified by multidisciplinary team. The diagnosis was based on Barcelona Clinic Liver Cancer (BCLC) staging system and depended upon typical findings on radiology using either multiphase CT or contrast-enhanced MRI of the abdomen ± AFP. Biopsy was performed for patients in whom Liver Reporting and Data System (LI-RADS) classification put the possible risk of mixed tumors and malignant non-HCC tumors.
Results
From a total 464 patients during period January 2022 to November 2023, 71 patients underwent liver biopsy due to atypical pattern characterization of the hepatic focal lesions in imaging techniques with normal AFP values. HCC was confirmed in 34 cases, benign lesions were diagnosed in two cases (one with dysplastic nodule and the other with focal nodular hyperplasia), 32 cases had non-HCC malignant tumors, and the last three cases had mixed HCC and cholangiocarcinoma. Immunohistochemistry using markers like Ki-67, chromogranin, synaptophysin, WT-1, CK-20 showed insignificant distribution between HCC and non-HCC groups, except CK-7 which was significantly higher in non-HCC vs. HCC group (61% vs. 20%, p = 0.050 [Fisher’s exact test]).
Conclusions
Based on our real-world data, about 48% of the cases turned out to be non-HCC, which is a huge number in oncology practice especially in the background of using of direct acting antiviral drugs for treatment of hepatic C virus So, we encourage physicians to request liver biopsy whenever the radiology and laboratory results are not fulfilling the criteria for HCC diagnosis.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.