Epidemiology of hepatocellular carcinoma in Bas-Rhin: analysis of all incident cases from 1990 to 1999.

In France, primary liver cancer--essentially represented by hepatocellular carcinoma--ranks 8th among the cancers in men, and incidence rates are increasing. The present study describes the epidemiological characteristics of hepatocellular carcinoma in BasRhin (lower Rhine region of Alsace) between 1990 and 1999. All the incident cases of hepatocellular carcinoma recorded in the cancer registry of Bas-Rhin between January 1st 1990 and December 31st 1999 were studied. Incidence rates were standardized on the world population, using the direct method. Survival was studied with the Kaplan-Meier method and a multivariate analysis was performed using the Cox model. A total of 845 cases of hepatocellular carcinoma were recorded. The incidence of hepatocellular carcinoma (histologically verified or not) remained stable over the whole period. The proportion of cases with underlying viral cirrhosis rose from 9% for the 1990-91 period up to 20% for the 1998-99 period (p=0.043). Overall survival after one year reached 35%. In multivariate analysis, the following variables were significantly related to survival: cirrhosis, Child-Pugh score, alphafoetoprotein level, type of tumour, portal vein thrombosis and type of treatment.