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

Objective: To describe the epidemiologic characteristics and clinical presentation 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 outpatient 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 hypertension 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 advanced 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 regarding the treatment of PLC and patient outcomes in the study setting is also needed.