Clinical profile and hepatocellular cancer treatment patterns in resource limited settings- a cross-sectional observational study at two tertiary referral teaching hospitals, Addis Ababa, Ethiopia

Abstract

BACKGROUND: Hepatocellular carcinoma (HCC) imposes a high global burden. A significant treatment gap exists in low- and middle-income countries (LMICs), where low rates of curative surgical intervention highlight profound healthcare inequities. OBJECTIVE: To evaluate the clinical profile and treatment patterns of HCC patients at TASH and SPHMMC Addis Ababa, Ethiopia. METHODS: This hospital-based cross-sectional observational study included 130 HCC patients. Continuous variables were assessed for normality using the Shapiro-Wilk test and described using means and ± SD, while medians and IQR used for skewed data. RESULTS: The mean age was 54.5 ± 16.5 years with a 63.1% male predominance. Although viral hepatitis was common (47.7%; HBV: 72.6%, HCV: 22.6%), a high proportion of patients (37.0%) presented with cryptogenic (unidentified) risk factors. Late-stage presentation was characteristic, evidenced by a mean tumor size of 10.0(± 4.6) cm and 63.8% of patients being BCLC stage C. 50% of cirrhotic patients were Child-Pugh B. These factors limited curative options, with resection performed in only 17.7% of the cohort, while 27.7% received TACE. CONCLUSION: Most HCC patients in this setting present with advanced-stage disease and large tumor burdens, leading to low curative resection rates. Addressing deficiencies in specialized human resources, infrastructure, and policy gaps is critical to improving access to life-saving surgical and loco-regional interventions.