الفهرس 
Contents
Microscopic AnatomyOnly 14 pages are availabe for public view
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Abstract
Summary and conclusion
Hepatocellular carcinoma (HCC) is a major global health problem. It is the fifth most common type of cancer and the third most common cause of cancer-related mortality in the world. Over 80% of HCC develops in cirrhotic liver, and is mainly attributable to chronic viral infection with hepatitis B or C.
HCC has a rising incidence in Egypt mostly due to high prevalence of viral hepatitis and its complications. It ranks second and sixth most common cancer among men and women respectively (Omar et al., 2013).
The goal of this retrospective study is to determine risk factors for HCC development in the Upper Egypt population and to determine the frequency of different modalities of management and their results.
This retrospective study was conducted on 146 recording sheets of patients with primary hepatocellular carcinoma (HCC) at clinical oncology department- Assiut university hospital and El rajhi Hospital of Assuit University in period from January 2012 to December 2014.
Our results showed that:
• The percentage of HCC cases among all cancer cases presented to clinical oncology department and El rajhi hospital in the period from 2012 to 2014 was about 7% with about 50 newly diagnosed cases per year
• HCC was predominant in males than females and more prevalent in patients with age group (50-60).
• high prevalence of HCV Ab followed by HBs Ag followed by combined hepatitis C and B and negative for viral markers of patients.
• 91% of the cases had liver cirrhosis
• statistically significant relation between tumor size and male gender and child pugh score. but, There is no statistical significant difference between alpha feto protein and either tumor size nor multiplicity,, also showed that no statistical significant difference between multiplicity of lesion and either hepatitis or child pugh score.
• The majority of cases were treated by TACE (27%), 24% received local ablation and 21% received chemotherapy “weekly gemzar”.
• Concerning the results of treatment :complete response was the most frequent result of resection/transplantation arm, followed by TACE and local ablation. Progression response was most commonly met with Best Supportive Care arm followed by chemotherapy
• There is high statistically significant difference between child pugh score of the patient and only TACE as a modality of treatment
• There is high statistically significant difference between size of the tumor (more or less than 5 cm) and local ablation,, Also shows that in single lesion/cases the most commonly used modalities were TACE and local ablation, while chemotherapy and best supportive care were least used. in cases with multiple lesions, local ablation and chemotherapy were most commonly used while resection and TACE were the least used.
• There is no statistically significant difference between different treatment modalities and underlying viral hepatitis. But high statistically significant difference between best supportive care and presence of liver cirrhosis
Recommendations
• Regular follow up of patients with cirrhosis or patients at high risk of developing HCC by regular ultrasonography check up every 3 - 6 months.
• screening programmes to detect HCV and HBV infection and treat the infected one
• Regular check up by doing alpha fetoprotein and abdominal ultrasound every 3-6 has benefit of detection of the HCC at early stage of the disease and enable curative therapy for it.
• We need more studies to evaluate different modalities of treatment and their response to determine which one is effective especially our results that most of patients with HCC were treated by TACE (27%) which was more frequent than surgical resection which was (13%).