AIPMED

ANNALS OF IBADAN POSTGRADUATE MEDICINE

PATTERN OF LIVER CANCER ADMISSIONS AT THE UNIVERSITY COLLEGE HOSPITAL, IBADAN - A 4-YEAR REVIEW

O. Adebayo, A. Lawal, and O.S. Ola

Department of Medicine, University College Hospital, Ibadan, Nigeria


ABSTRACT

Background: Liver Cancer (LC) is a common malignancy globally, and it exacts an enormous toll on the health care system. Therefore, it is imperative to have an epidemiological profile for effective planning.

Methods: This study examined the basic demographic, admission profile and outcome of this category of patients through a retrospective cross-sectional study. The study was carried out using data of clinical diagnoses of LC admitted into the Gastro-intestinal Unit (GLU), Department of Medicine, University College Hospital, Ibadan between 1st January 2011 and 31st December 2014.

Results: Two hundred and six patients (16.8%) had diagnoses of LC out of the 1228 total cases admitted by the GLU. The total male patients were 147(71.4%) and female 59 (28.6%) while the most prominent age group for both genders and males were 41-50 years in the male group and 51-60 years in the female. The mean + SD and median hospital stay was 10.6±11.6 days and eight days for LC patients, respectively. The intrahospital fatality rate was 37.9% and occurred mainly within five days of admission.

Conclusion: Liver Cancer is an important disorder in gastrointestinal practice and had high fatality within a few days of admission; hence, efforts should be made to improve the care of the patients.

Keywords: Liver cancer, Epidemiology, Nigeria, In-patient, Gastroenterology

Correspondence

Prof. S.O. Ola

Department of Medicine,

University College Hospital,

Ibadan, Oyo State

Nigeria

Email: soola2001@yahoo.com


BACKGROUND

Liver Carcinoma (LC) is the third most prevalent cause of cancer-related death worldwide.1 The incidence of LC is found to be 16 to 32 times higher in developing countries than in developed countries.1,2 Globally 550,000 to 600,000 new LC cases occur each year, and it is a leading cause of cancer death in sub-Saharan Africa with Mozambique having the highest incidence.1 The incidence is generally more in Africa and South East Asia where HBV and HCV infections are prevalent particularly for hepatocellular carcinoma (HCC) while cholangiocarcinoma (CCC) is commoner in areas with a high prevalence of Clonorchis Sinensis and Clonorchis viverrini.3, 4 

In the African population, the age-standardized incidence of HCC is as high as 41.2/100,000 persons/ year.1 Hepatocellular carcinoma affects male-female in ratio 4:1 globally, with 1:1 among those without cirrhosis, 9:1 in high incidence countrieswhile CCC is commoner in females.5 

There is a dearth of epidemiological studies on the disorder; however, the available studies showed that the disease constitutes a significant portion in gastroenterology consultations or malignancies that are encountered in Africa.6, 7 Out of the 4,568 deaths recorded in the medical wards of UCH, over 14 years (1960-1973) liver diseases were the third most common cause of death accounting for 12.1% of all deaths while PLCC was responsible for 42.5% of liver diseases related deaths.8 Liver cancer accounted for 44.3% of liver diseases admission at University of Nigeria Teaching Hospital, Nsukka.9

The disease constitutes a significant financial/economic burden on the affected patients, families, and caregivers generally, institutions and the society at large. While the exact figure of burden may not be known for Nigeria, the examination of the demographic pattern of this disease and health service utility would aid health system planning and development in this environment, since the burden of LC is expected to increase in the near future especially without implementing adequate preventive action.10 Furthermore, this exercise has a significant epidemiological value while serving as a clinical audit tool in the institution. 

This cross-sectional study determines the basic demographic characteristics; explores the case outcomes and examines the temporal profile of LC patients admitted into the male and female medical wards in University College Hospital (UCH), Ibadan.