Liver cancer in Malaysia: Epidemiology and clinical presentation in a multiracial Asian population

Khean Lee Goh, Hamizah Razlan, Juanda Leo Hartono, Choon Seng Qua, Boon Koon Yoong, Peng Soon Koh, Basri Johan Jeet Abdullah

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objective: Hepatocellular carcinoma (HCC) is an important cancer in Malaysia. This study aimed to determine the epidemiological characteristics and clinical presentations of patients in a multiracial population consisting of three major Asian races: Malays, Chinese and Indians. Methods: Consecutive patients with HCC were prospectively studied from 2006 to 2009. HCC was diagnosed principally on multiphasic computed tomography and magnetic resonance imaging scans of the liver. The tumor was staged according to the Barcelona Clinic Liver Cancer (BCLC) classification. Results: Altogether, 348 patients were diagnosed with HCC. There were 239 (68.7%) Chinese patients, 71 (20.4%) Malays and 38 (10.9%) Indians, with the median age of 62.5 years and the male to female ratio of 3.4:1. The predominant etiology in Malay and Chinese patients was hepatitis B virus infection (>60%) and in Indian patients was alcohol intake (26.3%) and cryptogenic cause (29.0%). Hepatitis C was seen in 18.3% of Malays, but less than 10% in Chinese and Indians. BCLC staging was: Stage A, 120 (34.5%); Stage B, 75 (21.6%); Stage C, 84 (24.1%); and Stage D, 69 (19.8%). A larger proportion of Indian than Chinese and Malays patients (44.7%) presented with stage D disease. Portal vein invasion was noted in 124 patients (35.6%) and extrahepatic metastases in 68 (19.5%). Surgical resection and radiofrequency ablation with curative intent was carried out in >90% of stage A patients and transarterial chemoembolization in 49.3% and 21.4% of stages B and C patients, respectively. Conclusions: HCC is most common among Chinese, followed by Malays and Indians in Malaysia. The etiology of HCC shows a peculiar racial pattern.

Original languageEnglish
Pages (from-to)152-158
Number of pages7
JournalJournal of Digestive Diseases
Volume16
Issue number3
DOIs
Publication statusPublished - 1 Mar 2015
Externally publishedYes

Fingerprint

Malaysia
Liver Neoplasms
Epidemiology
Hepatocellular Carcinoma
Population
Neoplasm Staging
Virus Diseases
Hepatitis C
Portal Vein
Hepatitis B virus
Neoplasms
Tomography
Alcohols
Magnetic Resonance Imaging
Neoplasm Metastasis
Liver

Keywords

  • BCLC staging
  • Chinese
  • Hepatocelluar carcinoma
  • Indian
  • Malay
  • Multiracial Asian population

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Goh, K. L., Razlan, H., Hartono, J. L., Qua, C. S., Yoong, B. K., Koh, P. S., & Abdullah, B. J. J. (2015). Liver cancer in Malaysia: Epidemiology and clinical presentation in a multiracial Asian population. Journal of Digestive Diseases, 16(3), 152-158. https://doi.org/10.1111/1751-2980.12223

Liver cancer in Malaysia : Epidemiology and clinical presentation in a multiracial Asian population. / Goh, Khean Lee; Razlan, Hamizah; Hartono, Juanda Leo; Qua, Choon Seng; Yoong, Boon Koon; Koh, Peng Soon; Abdullah, Basri Johan Jeet.

In: Journal of Digestive Diseases, Vol. 16, No. 3, 01.03.2015, p. 152-158.

Research output: Contribution to journalArticle

Goh, KL, Razlan, H, Hartono, JL, Qua, CS, Yoong, BK, Koh, PS & Abdullah, BJJ 2015, 'Liver cancer in Malaysia: Epidemiology and clinical presentation in a multiracial Asian population', Journal of Digestive Diseases, vol. 16, no. 3, pp. 152-158. https://doi.org/10.1111/1751-2980.12223
Goh, Khean Lee ; Razlan, Hamizah ; Hartono, Juanda Leo ; Qua, Choon Seng ; Yoong, Boon Koon ; Koh, Peng Soon ; Abdullah, Basri Johan Jeet. / Liver cancer in Malaysia : Epidemiology and clinical presentation in a multiracial Asian population. In: Journal of Digestive Diseases. 2015 ; Vol. 16, No. 3. pp. 152-158.
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abstract = "Objective: Hepatocellular carcinoma (HCC) is an important cancer in Malaysia. This study aimed to determine the epidemiological characteristics and clinical presentations of patients in a multiracial population consisting of three major Asian races: Malays, Chinese and Indians. Methods: Consecutive patients with HCC were prospectively studied from 2006 to 2009. HCC was diagnosed principally on multiphasic computed tomography and magnetic resonance imaging scans of the liver. The tumor was staged according to the Barcelona Clinic Liver Cancer (BCLC) classification. Results: Altogether, 348 patients were diagnosed with HCC. There were 239 (68.7{\%}) Chinese patients, 71 (20.4{\%}) Malays and 38 (10.9{\%}) Indians, with the median age of 62.5 years and the male to female ratio of 3.4:1. The predominant etiology in Malay and Chinese patients was hepatitis B virus infection (>60{\%}) and in Indian patients was alcohol intake (26.3{\%}) and cryptogenic cause (29.0{\%}). Hepatitis C was seen in 18.3{\%} of Malays, but less than 10{\%} in Chinese and Indians. BCLC staging was: Stage A, 120 (34.5{\%}); Stage B, 75 (21.6{\%}); Stage C, 84 (24.1{\%}); and Stage D, 69 (19.8{\%}). A larger proportion of Indian than Chinese and Malays patients (44.7{\%}) presented with stage D disease. Portal vein invasion was noted in 124 patients (35.6{\%}) and extrahepatic metastases in 68 (19.5{\%}). Surgical resection and radiofrequency ablation with curative intent was carried out in >90{\%} of stage A patients and transarterial chemoembolization in 49.3{\%} and 21.4{\%} of stages B and C patients, respectively. Conclusions: HCC is most common among Chinese, followed by Malays and Indians in Malaysia. The etiology of HCC shows a peculiar racial pattern.",
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N2 - Objective: Hepatocellular carcinoma (HCC) is an important cancer in Malaysia. This study aimed to determine the epidemiological characteristics and clinical presentations of patients in a multiracial population consisting of three major Asian races: Malays, Chinese and Indians. Methods: Consecutive patients with HCC were prospectively studied from 2006 to 2009. HCC was diagnosed principally on multiphasic computed tomography and magnetic resonance imaging scans of the liver. The tumor was staged according to the Barcelona Clinic Liver Cancer (BCLC) classification. Results: Altogether, 348 patients were diagnosed with HCC. There were 239 (68.7%) Chinese patients, 71 (20.4%) Malays and 38 (10.9%) Indians, with the median age of 62.5 years and the male to female ratio of 3.4:1. The predominant etiology in Malay and Chinese patients was hepatitis B virus infection (>60%) and in Indian patients was alcohol intake (26.3%) and cryptogenic cause (29.0%). Hepatitis C was seen in 18.3% of Malays, but less than 10% in Chinese and Indians. BCLC staging was: Stage A, 120 (34.5%); Stage B, 75 (21.6%); Stage C, 84 (24.1%); and Stage D, 69 (19.8%). A larger proportion of Indian than Chinese and Malays patients (44.7%) presented with stage D disease. Portal vein invasion was noted in 124 patients (35.6%) and extrahepatic metastases in 68 (19.5%). Surgical resection and radiofrequency ablation with curative intent was carried out in >90% of stage A patients and transarterial chemoembolization in 49.3% and 21.4% of stages B and C patients, respectively. Conclusions: HCC is most common among Chinese, followed by Malays and Indians in Malaysia. The etiology of HCC shows a peculiar racial pattern.

AB - Objective: Hepatocellular carcinoma (HCC) is an important cancer in Malaysia. This study aimed to determine the epidemiological characteristics and clinical presentations of patients in a multiracial population consisting of three major Asian races: Malays, Chinese and Indians. Methods: Consecutive patients with HCC were prospectively studied from 2006 to 2009. HCC was diagnosed principally on multiphasic computed tomography and magnetic resonance imaging scans of the liver. The tumor was staged according to the Barcelona Clinic Liver Cancer (BCLC) classification. Results: Altogether, 348 patients were diagnosed with HCC. There were 239 (68.7%) Chinese patients, 71 (20.4%) Malays and 38 (10.9%) Indians, with the median age of 62.5 years and the male to female ratio of 3.4:1. The predominant etiology in Malay and Chinese patients was hepatitis B virus infection (>60%) and in Indian patients was alcohol intake (26.3%) and cryptogenic cause (29.0%). Hepatitis C was seen in 18.3% of Malays, but less than 10% in Chinese and Indians. BCLC staging was: Stage A, 120 (34.5%); Stage B, 75 (21.6%); Stage C, 84 (24.1%); and Stage D, 69 (19.8%). A larger proportion of Indian than Chinese and Malays patients (44.7%) presented with stage D disease. Portal vein invasion was noted in 124 patients (35.6%) and extrahepatic metastases in 68 (19.5%). Surgical resection and radiofrequency ablation with curative intent was carried out in >90% of stage A patients and transarterial chemoembolization in 49.3% and 21.4% of stages B and C patients, respectively. Conclusions: HCC is most common among Chinese, followed by Malays and Indians in Malaysia. The etiology of HCC shows a peculiar racial pattern.

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KW - Malay

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