Characteristics of Hepatocellular Carcinoma in Two Tertiary Hospitals in Nigeria - Has anything Changed?

Characteristics of Hepatocellular Carcinoma in Two Tertiary Hospitals in Nigeria - Has anything Changed?

Loading document ...
Loading page ...


Author(s): Uchenna Okonkwo, Ruth Bello, Ogbu Ngim, Victor Nwagbara

Download Full PDF Read Complete Article

DOI: 10.18483/ijSci.1144 347 887 43-48 Volume 5 - Nov 2016


Hepatocellular carcinoma (HCC) is a global health problem accounting for 5.6% of all human cancers although less developed countries are disproportionately affected.[1]It is the fifth most common cancer in men (554,000 cases) and the ninth in women (228,000 cases). In both sexes, it is the sixth most common cancer responsible for 748, 000 new cases of cancer annually and the third leading cause of cancer related death exceeded only by cancers of the lung and stomach.[2]The incidence of HCC is increasing both in the developed and developing countries. This has been attributed to the rising prevalence of its risk factors; chronic hepatitis B and C infection, alcohol abuse, non-alcoholic fatty liver disease (NAFLD) associated with type 2 diabetes and obesity.[3-5] HCC is characterized by several epidemiological features including dynamic temporal trends, variation among geographic regions, racial and ethnic groups and the presence of several preventable risk factors.[6] Although HCC was one of the first cancers to be linked epidemiologically to hepatitis B virus which is preventable, its incidence remains high in regions of the world where the virus is endemic.[7] In 2002, it was estimated that 82% of all liver cancers occurred in the developing countries of south-eastern Asia and sub-Saharan Africa. In these regions, majority of HCC tend to occur in persons with chronic hepatitis B virus infection and to a lesser extent in patients with chronic hepatitis C virus infection.[1] Other potential contributory factors include high dietary exposure to aflatoxin, a common contaminant of foodstuffs such as nuts, grains and legumes, dietary iron overload, alcohol abuse and non-alcoholic steato-hepatitis (NASH) associated with type 2 diabetes and the metabolic syndrome.


  1. Yang JD, Roberts LR. Hepatocellular carcinoma: a global view. Nat Rev GastroenterolHepatol. 2010; 7(8): 448–458. doi: 10.1038/nrgastro.2010.100. Epub 2010 Jul 13.
  2. Ferlay J, et al. GLOBOCAN 2012, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10. Lyon, France: International Agency for Research on Cancer; 2010. [online],
  3. McGlynn KA, Tsao L, Hsing AW, Devesa SS, Fraumeni JF., International trends and patterns of primary liver cancer. Int J Cancer. 2001;94:290–296. [PubMed]
  4. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA cancer J Clin 2005;55
  5. Yuen MF, Tanaka Y, Fong DY, Fung J, Wong DK, Yuen JC et al. Independent risk factors and predictive score for the development of hepatocellular carcinoma in chronic hepatitis B. J Hepatol. 2009;50:80–88.
  6. Gomaa AI, Taylor-Robinson SD, Khan SA et al. Hepatocellular carcinoma: Epidemiology, risk factors and pathogenesis. World J Gastroenterol 2008, 14(27): 4300-4308. PMCID: PMC2731180. Free PMC Article
  7. Ladep NG, Lesi OA, Mark P, Lemoine M, Onyekwere CA, Afihene M et al. Problem of hepatocellular carcinoma in west Africa. World J Hepatol. 2014; 6(11): 783–792. doi: 10.4254/wjh.v6.i11.783
  8. Kew MC. Epidemiology of hepatocellular carcinoma in sub-Saharan Africa. Annals of hepatology, 2013; 12(2): 173-182.
  9. Okonkwo UC, Nwosu MN, Ukah C, Okpala OC, Ahaneku JI. The clinical and pathological features of hepatocellular carcinoma in Nnewi, Nigeria.
  10. Forner A, Reig ME, de Lope CR, Bruix J. Current strategy for staging and treatment: the BCLC update and future prospects. Semin Liver Dis. 2010;30:61–74. [PubMed]
  11. Chen MS, et al. A prospective randomized trial comparing percutaneous local ablative therapy and partial hepatectomy for small hepatocellular carcinoma. Ann Surg. 2006;243:321–328. [PMC free article]
  12. El-Serag HB, Rudolph KL. Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology. 2007;132:2557–2576.
  13. Fakunle YM, Ajdkiewiez AB, Greenwood BM, Edington GM. Primary Liver Cell Carcinoma in Northern Guinea Savanna of Nigeria. Trans. R. Soc. Trop. Med. Hyg. 1977;71: 335-337.
  14. Olubuyide IO, Aliyu B, Olaleye OA, Ola SO, Olawuyi F. Hepatitis B and C viruses and Hepatocellular cancer. Trans. R. Soc. Trop. Med. Hyg. 1997; 91: 30-41.
  15. Ndububa DA, Ojo OS, Adeodu OO, Adetiloye VA, Olasode BJ. Primary Hepatocellular carcinoma in Ile-Ife, Nigeria; A prospective study of 154 cases. Nig. J Med. 2001; 10: 59-63.
  16. Olubuyide IO. The Natural History of Primary Liver Cell Carcinoma. A Study of 89 Untreated Adult Nigerians. Cen. Afr. J. Med. 1992; 38:25-30
  17. Yu MW, Chen CJ. Elevated serum testosterone levels and risk of hepatocellular carcinoma. Cancer Res. 1993;53:790–794. [PubMed]
  18. Nwokediuko SC, Ijoma UN, Obienu O. Hepatocellular carcinoma in Enugu, South-eastern Nigeria. Insight Bioinformatics, 2011; 1 (1): 1-5. DOI: 10.5567/BIOINFO-IK.2011.1.5
  19. Mustapha SK, Bolori MT, Ajayi NA, et al.Hepatocellular Carcinoma In North- Eastern Nigeria: A Prospective Clinical Study Of 100 Cases. The Internet Journal of Gastroenterology. 2007; 6(1). ISSN 1528-8323.
  20. Ihekwaba AE, Nwankwo NC. Clinical profile of hepatocellular carcinoma at the University of Port Harcourt Teaching Hospital, Port Harcourt. Tropical Journal of Medical Research 2003;7(1): 26-28.
  21. Yang JD, Gyedu A, Afihene MY, Duduyemi BM, Micah E, Kingham TP et al. Hepatocellular Carcinoma Occurs at an Earlier Age in Africans, Particularly in Association with Chronic Hepatitis B. The American Journal of Gastroenterology 2015; 110: 1629-1631.
  22. Barin F, Perrin J, Chotard J, Denis F, N’Doye R, Diop Mar I, Chiron JP, Coursaget P, Goudeau A, Maupas P. Cross-sectional and longitudinal epidemiology of hepatitis B in Senegal. Prog Med Virol. 1981;27:148–162. [PubMed]
  23. Abiodun PO, Omoike UI. Hepatitis B in children in Benin City. Niger J paed. 1990; 17(1):27-31
  24. Otu MB, Akpan A. Hepatocellular carcinoma, Cirrhosis and hepatitis B infection in Nigeria. Cancer, 1987; 60: 2581-2585
  25. Ajayi BB, Nggada HA, Moses AE. Hepatocellular carcinoma among patients diagnosed with or without hepatitis B surface antigenemia in a Nigerian Tertiary hospital. African J of Microbiology Research 2007;1: 121-124
  26. Beasley RP, Hwang IY, Lin CC, Chen CS. Hepatocellular carcinoma and hepatitis B virus; A prospective study of 22,707 men in Taiwan. Lancet. 1981;2:1129-1133
  27. Pascual S, Irurzun J, Zapater P et al. Usefulness of surveillance programmes for early diagnosis of hepatocellular carcinoma in clinical practice. Liver int. 2008; 28(5):682-689.
  28. Llovet JM, Fuster J, Bruix J. Intention-to-treat analysis of surgical treatment for early hepatocellular carcinoma: resection versus transplantation. Hepatology. 1999;30:1434–1440. [PubMed]
  29. Ndububa DA1, Ojo OS, Aladegbaiye AO, Adebayo RA, Adetiloye VA, Durosinmi MA. Liver Cirrhosis: Child-Pugh grading of cases seen in Nigeria. Trop Doc. 2005; 35(3):169-171
  30. Okonkwo UC, Nwosu MN, Bojuwoye BJ. The predictive values of the MELD and Child-Pugh scores in determining mortality from chronic liver disease patients in Anambra state, Nigeria. The Internet Journal of Gastroenterology, 2011; 10(2): ISSN1528-8323
  31. Okonkwo UC., Onyekwere CA. Challenges in the management of chronic hepatitis B in West Africa; the Clinician’s perspective. Tropical Doctor. 2014; 46(1) 16–20
  32. Okonkwo UC, Ngim OE, Osim H, Inyama MA, Kooffreh-Ada M, Esu E et al. Knowledge of hepatitis B virus amongst traders in Calabar. Nigerian Journal of Clinical practice. (In press).

Cite this Article:

International Journal of Sciences is Open Access Journal.
This article is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0) License.
Author(s) retain the copyrights of this article, though, publication rights are with Alkhaer Publications.

Search Articles

Issue June 2023

Volume 12, June 2023

Table of Contents

World-wide Delivery is FREE

Share this Issue with Friends:

Submit your Paper