Journal of Medical and Surgical Research

5

Authors: M. Allaoui, JJ. Michels

Aim: The purposes of this study is to identify the incidence of uterine adenosarcomas in Lower Normandy. In addition, we sought the clinical, morphological, and immunohistochemical features of this uncommon mixed mesenchymal tumors. Patients and methods: 13 cases of uterine adenosarcomas were retrieved the last 23 years from the charts of the François Baclesse Cancer Center and thanks to the data obtained from the cancer registries of the department of Manche and Calvados in Lower Normandy (France). All cases were reviewed by the authors. Results: 13 cases were observed beginning with the first case reported in our geographic area in 1989. Follow-up was available in 11 cases, only one young patient died, but from another non related previous carcinoma. All other patients are actually alive with no evidence of disease with a median follow-up of 10 years, only one patient with short follow-up shows a very ominous local evolution with a massive intraabdominal evolution in the context of an heterologous adenosarcoma with a rhabdomyosarcomatous component.

8

Authors: Y. Cherradi, R. Afifi, H. Benbrahim, W. Essamri, I. Benelbarhdadi, F. Z Ajana, M. Benazzouz, A. Essaid

Introduction: Hepatitis C is the first aetiologic agent for HCC in Morocco. Antiviral treatment reduces the risk of developing HCC in patients with chronic hepatitis C but few cases of HCC have been still reported. We aimed to define population with high risk of HCC occurrence, confirm the protective role of SVR and to identify predictive factors of developing HCC after SVR. We’ll try to present suggestions about screening strategies (indications and interval) after antiviral therapy according to level of HCC occurrence risk. Patients and Methods: We included all patients with chronic hepatitis C treated in our department from January 2002 to April 2010. We compare HCV-treated patients with no developed HCC to HCC population using khi-2 and Fisher Exact analysis. Results: 369 patients treated for hepatitis C were considered, and 20 HCC were reported. The risk of HCC occurrence was not significant according to gender and genotypes. Advanced age and severe fibrosis were significant risk factors. HCC was reported in 2.3% of sustained virological responders versus 12.5% of non responders. SVR is a significant protective factor. Conclusion: In our series, 5% of previously treated HCV carriers developed HCC and 2.3% of sustained virological responders developed. Achieving SVR after antiviral therapy is a protective factor. Advanced age (> 50 y. o), severe fibrosis (F>2) and lack of SVR at HCV diagnosis are predictive factors of HCC development in treated patients. Regular bi-annual ultrasonography screening should be indicated necessarily in patients with advanced fibrosis stage (F3- F4) even after SVR, particularly when co-morbid conditions are associated (advanced age, NASH, diabetes mellitus,…). Screening interval in sustained virological responders with reduced fibrosis stage may be reduced to annual surveillance. Establishing guidelines about consensual strategy to survey sustained virological responders is now necessary especially with high rates of SVR and the extension of treatment indications in era of DAA drugs.