DOI QR코드

DOI QR Code

Characteristics of Liver Cancer at Khmer-Soviet Friendship Hospital in Phnom Penh, Cambodia

  • Narin, Piseth (Department of International Cooperation, Ministry of Health) ;
  • Hamajima, Nobuyuki (Department of Healthcare Administration, Nagoya University Graduate School of Medicine) ;
  • Kouy, Samnang (Oncology Department, Khmer-Soviet Friendship Hospital) ;
  • Hirosawa, Tomoya (Department of Healthcare Administration, Nagoya University Graduate School of Medicine) ;
  • Eav, Sokha (National Cancer Center, Calmette Hospital)
  • Published : 2015.02.04

Abstract

Background: Hepatocellular carcinoma (HCC) is one of the most frequent cancers in South East Asian countries including Cambodia, where prevalence of chronic carriers of hepatitis B and C virus (HBV and HCV) is reported to be very high. We reviewed HCC cases admitted to a cancer hospital in Phnom Penh, which is the only one hospital for cancer treatment and care in Cambodia during the study period. Materials and Methods: Information was collected from medical records of 281 cases (210 males and 71 females) diagnosed as primary HCC from 2006 to 2011. Results: The subjects were 7-81 years old with a median age of 53 years. Hypochondriac pain was the most common complained symptom (74%). One third of the cases presented with jaundice. Nearly half had ascites at their first visit. One third had liver cirrhosis. Nearly three fourths of the cases presented with tumor sized more than 50 mm in diameter, and in almost all cases (97.4%) the size was more than 20 mm. Among 209 subjects tested, hepatitis virus carriers were 75.6%; 46.4% for HBV only, 21.5% for HCV only, and 7.7% for both viral infections. Median age of patients with HBV was about ten years younger than those with HCV. Conclusions: This study revealed the characteristics of HCC cases in Cambodia, although there were several limitations. Most HCC cases were infected with HBV and/or HCV, and diagnosed at late stages with complications. This implicated that public health intervention to prevent HBV and HCV infection is of high priority.

Keywords

References

  1. Akkarathamrongsin S, Praianantathavorn K, Hacharoen, et al. (2011). Seroprevalence and genotype of hepatitis C virus among immigrant workers from Cambodia and Myanmar in Thailand. Intervirology, 54, 10-6. https://doi.org/10.1159/000318884
  2. Boucharrdy C, Park In DM, Khlat M (1994). Cancer among Chinese and South-East Asian immigrants in France. Int J Cancer, 58, 638-43. https://doi.org/10.1002/ijc.2910580504
  3. Buchy P, Monchy D, An TT, et al (2004). Prevalence of hepatitis A, B, C and E virus markers among patients with elevated levels of alanine aminotransferase and aspartate aminotransferase in Phnom Penh (Cambodia) and Nha Trang (Central Vietnam). Bull Soc Pathol Exot, 97, 165-71.
  4. Caruana SR, Kelly HA, De Silva SL, et al (2005). Knowledge about hepatitis and previous exposure to hepatitis viruses in immigrants and refugees from the Mekong Region. Aust N Z J Pub Health, 29, 65-8.
  5. Ding X, Park YN, Taltavull TC, et al (2003). Geographic characterization of hepatitis virus infections, genotyping of hepatitis B virus, and p53 mutation in hepatocellular carcinoma analyzed by in situ detection of viral genomes from carcinoma tissues: comparison among six different countries. Jpn J Infect Dis, 56, 12-8.
  6. Eav S, Schraub S, Dufour P, et al (2012). Oncology in Cambodia. Oncol, 82, 269-74. https://doi.org/10.1159/000336791
  7. Galy O, Chemin I, Le Roux E, et al (2011). Mutations in TP53 and CTNNB1 in relation to hepatitis B and C infections in hepatocellular carcinomas from Thailand. Hepat Res Treat, 2011, 697162.
  8. Ha SL, Bjoerkvoll B, Sothy S, et al (2009). Prevalence of hepatitis B and hepatitis C virus infection in potential blood donors in rural Cambodia. Southeast Asian J Trop Med Public Health, 40, 963-71.
  9. Hiotis SP, Rahbari NN, Villanueva GA, et al (2012). Hepatitis B vs hepatitis C infection on viral hepatitis-associated hepatocellular carcinoma. BMC Gastroenterol, 12, 64. https://doi.org/10.1186/1471-230X-12-64
  10. Jan S, Kimman M, Kingston D, Woodward M (2012). The socioeconomic burden of cancer in member countries of the Association of Southeast Asian Nations (ASEAN) stakeholder meeting report. Asian Pac J Cancer Prev, 13, 407-9. https://doi.org/10.7314/APJCP.2012.13.2.407
  11. Jun Lv, Ya-Qun Yu, Shu-Qun Li, et al (2014). Aflatoxin B1 promotes cell growth and invasion in hepatocellular carcinoma HepG2 cells through H19 and E2F1. Asian Pac J Cancer Prev, 15, 2565-70 https://doi.org/10.7314/APJCP.2014.15.6.2565
  12. Kew MC (2010). Epidemiology of chronic hepatitis B virus infection, hepatocellular carcinoma, and hepatitis B virusinduced hepatocellular carcinoma. Pathol Biol, 10, 273-7.
  13. Kew MC (2012). Hepatocellular carcinoma in developing countries: prevention, diagnosis and treatment. World J Hepatol, 4, 99-104. https://doi.org/10.4254/wjh.v4.i3.99
  14. Kimman M, Norman R, Jan S, et al (2012). The burden of cancer in member countries of the Association of Southeast Asian Nations (ASEAN). Asian Pac J Cancer Prev, 13, 411-20. https://doi.org/10.7314/APJCP.2012.13.2.411
  15. Kowdley KV, Wang CC, Welch S, Roberts H, Brosgart CL (2012). Prevalence of chronic hepatitis B among foreignborn persons living in the United States by country of origin. Hepatology, 56, 422-33. https://doi.org/10.1002/hep.24804
  16. Kudo M, Izumi N, Kokudo N, et al (2011). Management of hepatocellular carcinoma in Japan: consensus-based clinical practice guidelines proposed by the Japan society of hepatology (JSH) 2010 updated version. Dig Dis, 29, 339-64. https://doi.org/10.1159/000327577
  17. Leerapun A, Thaikruea L, Pisespongsa P, et al (2013). Clinical features and prognostic factors for liver cancer from a referral center in northern Thailand. J Med Assoc Thai, 96, 531-7.
  18. Ngoan LT, Lua NT, Hang LT (2007). Cancer mortality pattern in Viet Nam. Asian Pac J Cancer Prev, 8, 535-8.
  19. Ngoan LT, Yoshimura T (2001). Liver cancer in Viet Nam: risk estimates of viral infections and dioxin exposure in the south and north populations. Asian Pac J Cancer Prev, 2, 199-202.
  20. Nguyen TL, Nguyen DC, Nguyen TH, et al (2011). Surveybased cancer mortality in the Lao PDR, 2007-08. Asian Pac J Cancer Prev, 12, 2495-8.
  21. Norsa'adah B, Nurhazalini-Zayani CG (2013). Epidemiology and survival of hepatocellular carcinoma in North-east Peninsular Malaysia. Asian Pac J Cancer Prev, 14, 6955-9. https://doi.org/10.7314/APJCP.2013.14.11.6955
  22. Perz JF, Armstrong GL, Farrington LA, Hutin YJ, Bell BP (2006). The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. J Hepatol, 45, 529-38. https://doi.org/10.1016/j.jhep.2006.05.013
  23. Somboon K, Siramolpiwat S, Vilaichone RK (2014). Epidemiology and survival of hepatocellular carcinoma in the central region of Thailand. Asian Pac J Cancer Prev, 15, 3567-70. https://doi.org/10.7314/APJCP.2014.15.8.3567
  24. Sa-Nguanmoo P, Tangkijvanich P, Thawornsuk N, et al (2010). Molecular epidemiological study of hepatitis B virus among migrant workers from Cambodia, Laos and Myanmar to Thailand. J Med Virol, 82, 1341-9. https://doi.org/10.1002/jmv.21828
  25. Sann CS, Rani M, Huong V, et al (2009). Results from nationwide hepatitis B serosurvey in Cambodia using simple and rapid laboratory test: implications for national immunization program. Am J Trop Med Hyg, 81, 252-7.
  26. Sarmati L, Andreoni M, Suligoi B, et al (2003). Infection with human herpesvirus-8 and its correlation with hepatitis B and C virus markers among rural population in Cambodia. Am J Trop Med Hyg, 68, 501-2.
  27. Srivatanakul P (2001). Epidemiology of liver cancer in Thailand. Asian Pac J Cancer Prev, 2, 117-21.
  28. Tangkijvanich P, Suwangool P, Mahachai V (2003). Comparison of clinical features and survival of patients with hepatitis B- and hepatitis C-associated hepatocellular carcinoma in Thailand. J Med Assoc Thai, 86, 250-6
  29. Tanizaki H, Ryu M, Kinoshita T, et al (1997). Comparison of clinical features and survival in patients with hepatitis B and C virus-related hepatocellular carcinoma. Jpn J Clin Oncol, 27, 67-70. https://doi.org/10.1093/jjco/27.2.67
  30. Thuring EG, Joller-Jemelka HI, Sareth H, et al (1993). Prevalence of markers of hepatitis viruses A, B, C and of HIV in healthy individuals and patients of a Cambodian province. Southeast Asian J Trop Med Public Health, 24, 239-49.
  31. Villar S, Ortiz-Cuaran S, Abedi-Ardekani B, et al (2012). Aflatoxin-induced TP53 R249S mutation in hepatocellular carcinoma in Thailand: association with tumors developing in the absence of liver cirrhosis. PLoS One, 7, 37707. https://doi.org/10.1371/journal.pone.0037707

Cited by

  1. A seroepidemiological survey of the effect of hepatitis B vaccine and hepatitis B and C virus infections among elementary school students in Siem Reap province, Cambodia pp.13866346, 2017, https://doi.org/10.1111/hepr.12941