Epidemiologic Characteristics and Clinical Presentation of Primary Liver Cancer: A Single-Center Observational Study at Tengandogo University Hospital, Burkina Faso

---

Résumé

Abstract
Objective: To describe the epidemiologic characteristics and clinical presenta
tion of Primary liver cancer (PLC) at Tengandogo University Hospital (Centre
Hospitalier Universitaire of Tengandogo, CHU-T) in Ouagadougou, Burkina
Faso. Methods: This was a retrospective observational study conducted at CHU
T, from 1 May 2013 to September 30, 2023. All patients seen for PLC in out
patient consultation or inpatient hospitalization were included. Results: One
hundred and twenty-four (124) cases of PLC were included, representing an
annual average of 11.8 cases. The mean age was 49.6 years, with the age group
of 40 - 50 years most commonly represented. The male-to-female sex ratio was
4.2. The majority of patients (56.5%, n = 70) had a WHO performance status
score of 3 (patient confined to bed or a wheelchair > 50% of waking hours).
Abdominal pain (64.5%, n = 80) and hepatomegaly (85.5%, n = 106) were the
most common clinical signs. The main etiological factor was hepatitis B virus
infection (59.7%, n = 74). An alpha-fetoprotein (AFP) level greater than or
equal to 400 ng/ml was observed in 51.3% of patients (n = 59). In the majority of cases, radiological examinations revealed large masses involving the right
lobe of the liver, with a significant proportion of multinodular tumors (45.7%,
n = 21). Masses were larger than 3 cm in 80.4% of cases (n = 37). Portal hy
pertension and portal vein thrombosis were associated with these lesions in
23.5% (n = 16) and 22.0% (n = 15) of cases, respectively. The most common
histological type of PLC (85.7%, n = 18) was hepatocellular carcinoma (HCC).
The Barcelona Clinic for Liver Cancer (BCLC) classification identified ad
vanced stage in 35.6% of cases (n = 42) and terminal stage in 34% of cases (n
= 40). Conclusion: The clinical presentation and diagnosis of PLC are often
delayed at CHU-T. The predominant histological type observed was HCC,
most commonly associated with hepatitis B virus. Emphasis should be placed
on viral hepatitis awareness and screening campaigns as well as hepatitis B
vaccination to reduce the incidence of this fatal disease. Further research re
garding the treatment of PLC and patient outcomes in the study setting is also
needed.

Mots-clés

Cancer, Liver, Hepatitis B/C, Burkina Faso