What do you know about hepatocellular carcinoma in Oman?

Approximately 60 cases of hepatocellular carcinoma (HCC) were detected in Oman in 2019, according to the latest statistics from the Ministry of Health, while the actual number is higher. Approximately 85% of HCC cases occurs in the presence of damaged liver parenchyma including; chronic viral hepatitis B, fatty liver disease and liver cirrhosis which has many causes itself. While 15% of HCC cases occurs in normal liver.

The two crucial causes of liver cirrhosis in our society are:

1. Chronic viral hepatitis B, which is widespread before the era of hepatitis B vaccine. The prevalence of viral hepatitis C is less than that of type B due to the difference in the method of transmission. The good thing currently is the availability of hepatitis B vaccine and the discovery of a curative treatment for viral hepatitis B.

2.Fatty liver disease, the number of which has increased according to what we have observed and the major predisposing factors includes the poor quality of food, lack of movement and exercise and alcohol consumption.

How can hepatocellular carcinoma be treated?

It depends on two main factors: First, the extent of the disease inside and outside the liver. The second one is the degree of liver cirrhosis – if any.

Locoregional treatments are generally better in early and intermediate stages, and the options include resection, liver transplantation, thermoablation, and trans-arterial chemo or radioembolization.

Liver transplantation is the best treatment in the case of liver cirrhosis if the patient and the disease characteristics are within the transplantation criteria the liver transplantation program is currently available in Oman.

What about advanced cases?

In general, the systemic or best supportive care are suggested. As for systemic treatments, there are promising results of immunotherapy that have given better results than chemotherapy in some carefully selected cases.