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Clinical features in hepatocellular carcinoma and the impact of autopsy on diagnosis. A study of 530 cases from a low-endemicity area
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- Kaczynski, Jerzy, 1951 (författare)
- Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute
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Hansson, G. (författare)
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- Wallerstedt, Sven, 1944 (författare)
- Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute
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(creator_code:org_t)
- 2005
- 2005
- Engelska.
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Ingår i: Hepatogastroenterology. - 0172-6390. ; 52:66, s. 1798-802
- Relaterad länk:
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https://gup.ub.gu.se...
Abstract
Ämnesord
Stäng
- BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) had been one of the malignancies with the highest reported increase of incidence in Sweden, but during the late 20-year period the incidence has been decreasing. The aims of our study were to state the impact of autopsy on diagnosis and to identify clinical characteristics in HCC. METHODOLOGY: This retrospective study was performed in Goteborg, Sweden and included all cases with a diagnosis of liver cancer from a period with a high autopsy frequency (1958-1979). The cases were reevaluated histopathologically and the autopsy records as well as the case files were scrutinized. RESULTS: The majority (63%) of the 530 biopsy verified cases of HCC were diagnosed unexpectedly at autopsy. Cirrhosis of the liver could be established in 71% of the cases, but was diagnosed or at least clinically suspected before the diagnosis of the tumor only in a minority (19%) of all HCC patients. At presentation, malaise (85%), weight loss (78%), anorexia (67%) and hepatomegaly (84%) were common. The median survival time from diagnosis was one month. In most cases (92%) the cause of death was either directly or indirectly related to HCC and/or underlying liver disease such as advanced tumor disease, hepatic failure and gastrointestinal bleeding. Spontaneous rupture of HCC was the cause of death in 17 cases (3%) CONCLUSIONS: In an unselected population in a low incidence area of HCC, most patients have clinically unknown cirrhosis of the liver and present with vague general paramalignant symptoms. HCC has an extremely poor prognosis. Since HCC, in a majority of cases, remains undiagnosed before death, the autopsy has great impact on the diagnosis. This should be considered in interpretation of results from epidemiological studies.
Nyckelord
- Adolescent
- Adult
- Age Distribution
- Aged
- Aged
- 80 and over
- Autopsy
- Biopsy
- Needle
- Carcinoma
- Hepatocellular/*epidemiology/*pathology/surgery
- *Cause of Death
- Child
- Endemic Diseases/*statistics & numerical data
- Female
- Hepatectomy/methods
- Humans
- Immunohistochemistry
- Incidence
- Liver Function Tests
- Liver Neoplasms/*epidemiology/*pathology/surgery
- Male
- Middle Aged
- Neoplasm Staging
- Retrospective Studies
- Sex Distribution
- Survival Analysis
- Sweden/epidemiology
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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