BACKGROUND AND OBJECTIVES: Previous studies using older diagnostic criteria indicated chronic Hepatitis B and alcohol as the most common etiologies of HCC in the Philippines. No recent studies updated criteria for diagnosis have been published. This study used the diagnostic criteria from the latest APASL guidelines to describe the demographic profile of patients with HCC.

METHODS: This is a cross-sectional study of adult HCC cases from a liver tumor registry in the Philippine General Hospital from 2009 to 2012. Demographics, AFP levels, BCLC stage, Child-Pugh Score, ECOG performance status, treatments received, and mortality were assessed.

RESULTS: The HCC prevalence rate was 7.8%, mostly occurring between ages 40 to 65 years. It is more common in males (M:F=4:1). Most of the HCC cases were diagnosed at early stages, with less severity of liver functional impairment compared to older studies. Resection was the common treatment undertaken (50%) and overall mortality rate at the time of hospital discharge was 25%. 

CONCLUSION: The profile of HCC patients in this study is similar to previous studies. More cases were recognized at earlier stages with better liver function, implying better treatment outcomes with surgery, although selection bias is recognized.

Human ; Male ; Female ; Middle Aged ; Adult ; Hepatitis B, Chronic ; Prevalence ; Selection Bias ; Hospitals, General ; Liver Neoplasms ; Alcohols

Rationale. COVID-19 pandemic disease, can be transmitted during gastrointestinal procedures, via aerosolized droplets, and via fecal shedding. Both international and local endoscopy societies have issued strategies to alleviate the risk to endoscopy personnel. However, several barriers against the implementation of these recommendations exist thus individual center’s policies are employed whenever applicable. Objectives. This narrative study aims to describe the current experience and set-up in the endoscopy unit of a COVID referral center, discuss the stratification of patients for endoscopy, the operational management of the personnel and endoscopy unit in line with the adapted local and international guidelines and offer endoscopists a quick reference guide to adapt endoscopy practice during the pandemic in a resource-limited setting. Methodology. This paper reviews and consolidates current endoscopy guidelines and describes the single-center experience of Philippine General Hospital. Results. In resource-limited settings, with uncertainties of prolonged COVID-19 impact to healthcare, modification of practice, adherence to strategies and recommendations, empowerment of workforce, establishing the sustainability of resources, training, and service to patients, are essential components to combat current dilemma brought about by this pandemic. Conclusion. Integration of current local and international guidelines encompass all aspects of endoscopy practice during the pandemic. The recommendations cited are aimed to guide other resource-limited endoscopy units for potential changes and guidance in the overall practice.
COVID-19

Gastroenterology ; Endoscopy, Gastrointestinal ; Consensus ; Colorectal Neoplasms ; Survival Rate ; Incidence ; Philippines ; Colonic Polyps ; Adenoma