Clinical predictors of patients with hepatocellular carcinoma: a systematic review

Introduction: Hepatocellular carcinoma is among the most incidente cancers in adults, representing worldwide the fifth most common type of cancer in men and the seventh in women, with an estimated 841,000 new cases reported in 2018. Moreover, it is considered a major global health challenge because it has a high mortality rate (93%) after the onset of clinical manifestations when associated with late diagnosis. Objective: To conduct a review of the scientific evidence of clinical predictors related to the development of hepatocellular carcinoma. Methods: This is a systematic review that followed the recommended steps of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses – PRISMA. We adopted the PICO strategy, which guided the research question: What is the scientific evidence indicated by the studies on the main clinical predictors of patients with hepatocellular carcinoma? In order to answer this question, we searched for studies in the respective databases, such as PubMed, Scopus, CINAHL, Web of Science and The Cochrane Data Base, using the descriptors in English, selected from Medical Subject Headings – MeSH. Accordingly, we identified 12 articles in the databases. Soon after the cataloging process, we decided to analyze only clinical trials, by means of the Consolidated Standards of Reporting Trials – CONSORT. With this, we considered the studies that reached a percentage of methodological quality greater than and equal to 60%, categorized as satisfactory. Accordingly, the final sample of the study consisted of five articles. Results: Despite significant advances in the early diagnosis and immediate treatment of hepatocellular carcinoma, according to a cohort study published in 2019 by the Journal of Research in Medical Sciences, the interval between diagnosis and death in patients with hepatocellular carcinoma is 5 years. The characteristic clinical predictors of the development of this disease are directly associated with staging and indicate the degree of involvement of the affected organ, in this case, the liver. A study reveals that abdominal pain is present in 40 to 60% of patients, abdominal distention and inappetence in 45%, jaundice in 16% and the presence of a palpable mass in the right hypochondrium in 23%. Conclusion: We noted that the previous identification of clinical predictors are sensitive tools to define the diagnosis and treatment of hepatocellular carcinoma.