A Comparison of Presentation, Treatment, and Survival After Hepatocellular Carcinoma of Viral and Non-Viral Etiology in Damietta, Egypt, 2007–2019

Abstract

Context

The difference in prognosis between patients diagnosed with viral versus non-viral hepatocellular carcinoma (HCC) in Egypt remains unclear.

Methods

We used data from patients diagnosed with HCC between 2007 and 2019 from a large monocentric retrospective cohort at the Damietta Oncology referral center (northern Egypt). Presentation and treatment were compared between viral versus non-viral etiology HCC patients. Survival was compared relying on univariate and multivariate Cox regressions.

Results

Data from 4714 HCC patients were analyzed. Among them, 204 (4.3%) presented with a non-viral etiology. Patients with non-viral versus viral etiology had a similar presentation overall, especially regarding the BCLC stage at HCC diagnosis. After controlling for various individual characteristics, patients with non-viral versus viral etiology had poorer survival (adjusted Hazard Ratio: 1.244; 95% Confidence Interval: 1.069–1.447).

Conclusion

Despite similar features, patients with non-viral- related HCC had poorer survival compared to patients with viral-related HCC.

Keywords:

• hepatocellular carcinoma
• liver cancer
• viral etiology
• non-viral etiology
• survival
• epidemiology

Data Sharing Statement

Data related to this study are available upon a reasonable request through an Email to the corresponding author.

Ethical Clearance

This study received approval from the Research Ethics Committee for Human Subject Research at Air Force Specialized Hospital and from the Egyptian Ministry of Health on 31st July 2019 and on October, 9th 2019, respectively. The data collected were anonymised and retrospective in nature, therefore the requirement for informed consent has been waived by both ethics committees. The study complies with the Declaration of Helsinki.

Disclosure

The authors declare no competing interests in this work.

Additional information

Funding

This research has been funded by the Pasteur Foundation US. The funders had no role in study design, data collection, data analysis, data interpretation, or writing of the article.