A Twelve-Year Retrospective Study Of Liver Cancer At Calmette Hospital In Cambodia; Contribution Of Viral Hepatitis

François CHASSAGNE, Université de Toulouse, IRD, UPS, France
ROJAS ROJAS T. 1 , SOKHA E. 2 , BERTANI S. 3 , PINEAU P. 4,5 , DEHARO E. 3

1 UMR912 SESSTIM, Aix Marseille Université, Marseille, France
2 National Cancer Centre, Calmette Hospital, Phnom Penh, Cambodia
3 UMR152 PHARMADEV, Université de Toulouse, IRD, UPS, Toulouse, France
4 Unité d’Organisation Nucléaire et Oncogenèse, Institut Pasteur, Paris, France
5 U993, Institut National de la Santé et de la Recherche Médicale, Paris France

Purpose
Cambodia lacks a national cancer registry, consequently no reliable data are available for estimating the incidence and the mortality of patients with cancer in the country. Nevertheless, based on estimates, liver cancer is supposed to be the main cancer among males with the highest incidence and mortality rate. Our objective was to describe the clinico-epidemiological characteristics of Cambodian liver cancer patients attending one of the two public hospitals specialising in oncology in Phnom Penh.
 
Methods
A retrospective study was carried out at the Calmette hospital where 553 medical charts were reviewed, covering the period from January 2003 to May 2015. Socio-demographic data, tumour presentation, clinical manifestations, serological data, biochemical features and medical imaging were obtained from both oncology and hepato-gastroenterology departments.
 
Results
Hepatocellular carcinoma (HCC) was the predominant type of liver cancer (511 cases, 92.4%), while cholangiocarcinoma (CCA) represented only 7.6% (42 cases). Of the 511 HCC, chronic hepatitis B (HBV) and C (HCV) virus showed similar rates with 207 AgHBs+ and 201 anti-HCV+ cases, respectively. About two-thirds of HCC patients had a tumour larger than 50 mm, in most cases multifocal. Most HCC (84%) and CCA (73.8%) patients received palliative treatment only.
 
Conclusions
The present study reveals that HCC is the main form of liver cancer at the Calmette Hospital in Phnom Penh. Both HBV and HCV infection contribute to HCC, indicating that HCV-HCC patients should be closely monitored. The creation of cancer registries, the surveillance of populations at risk to develop HCC or CCA and the prevention of infectious agents should become a priority for health policy-makers.
 
Funding sources
This work was funded by the Fondation pour la Recherche Médicale (FRM), the French National Alliance for Life Sciences and Health (Aviesan) and the Peruvian Fund for Innovation, Science, and Technology (FINCyT).