2Department of Gastroenterology, Çukurova University, Faculty of Medicine, Adana, Turkiye
3Department of Gastroenterology, Mersin University, Faculty of Medicine, Mersin, Turkiye
4Department of Gastroenterology, Marmara University, Faculty of Medicine, Istanbul, Turkiye
5Department of Gastroenterology, Gaziantep University, Faculty of Medicine, Gaziantep, Turkiye
6Department of Gastroenterology, Ankara University, Faculty of Medicine, Ankara, Turkiye
7Department of Gastroenterology, University of Health Sciences Turkey, Umraniye Training and Research Hospital, Istanbul, Turkiye
8Department of Gastroenterology, Health Sciences University, Ankara City Hospital, Ankara, Turkiye
9Department of Gastroenterology, Hacettepe University, Faculty of Medicine, Ankara, Turkiye
10Department of Gastroenterology, Ege University, Faculty of Medicine, Izmir, Turkiye
11Department of Gastroenterology, Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkiye
12Department of Gastroenterology, Recep Tayyip Erdogan University, Faculty of Medicine, Rize, Turkiye
13Department of Gastroenterology, Ondokuz Mayis University, Faculty of Medicine, Samsun, Turkiye
14Department of Gastroenterology, Mustafa Kemal University, Faculty of Medicine, Hatay, Turkiye
15Department of Gastroenterology, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkiye
Background and Aim: The aim of the present study was to examine the etiology of hepatocellular carcinoma (HCC) by underlying cause and determine the characteristics and clinical features of patients with HCC.
Material and Methods: The study comprised 1802 HCC patients diagnosed and followed up by Liver Diseases Outpatient Clinics in 14 tertiary centers in Turkey between 2001 and 2020.
Results: The mean age was 62.3±10.7 years, and 78% of them were males. Of the patients, 82% had cirrhosis. Hepatitis B virus (HBV) infection was the most common etiology (54%), followed by hepatitis C virus (HCV) infection (19%) and nonalcoholic fatty liver disease (NAFLD) (10%). Of the patients, 56% had a single lesion. Macrovascular invasion and extrahepatic spread were present in 15% and 12% of the patients, respectively. The median serum alpha-fetoprotein level was 25.4 ng/mL. In total, 39% of the patients fulfilled the Milan Criteria. When we compared the characteristics of patients diagnosed before and after January 2016, the proportion of NAFLD-related HCC cases increased after 2016, from 6.6% to 13.4%.
Conclusion: Chronic HBV and HCV infections remain the main causes of HCC in Turkey. The importance of NAFLD as a cause of HCC is increasing.