Clinical profile and hepatocellular cancer treatment patterns in resource limited settings- a cross-sectional observational study at two tertiary referral teaching hospitals, Addis Ababa, Ethiopia

Hepatocellular carcinoma (HCC) imposes a high global burden. A significant treatment gap exists in low- and middle-income countries (LMICs), where low rates of curative surgical intervention highlight profound healthcare inequities. To evaluate the clinical profile and treatment patterns of HCC patients at TASH and SPHMMC Addis Ababa, Ethiopia. This hospital-based cross-sectional observational study included 130 HCC patients. Continuous variables were assessed for normality using the Shapiro-Wilk test and described using means and ± SD, while medians and IQR used for skewed data. The mean age was 54.5 ± 16.5 years with a 63.1% male predominance. Although viral hepatitis was common (47.7%; HBV: 72.6%, HCV: 22.6%), a high proportion of patients (37.0%) presented with cryptogenic (unidentified) risk factors. Late-stage presentation was characteristic, evidenced by a mean tumor size of 10.0(± 4.6) cm and 63.8% of patients being BCLC stage C. 50% of cirrhotic patients were Child-Pugh B. These factors limited curative options, with resection performed in only 17.7% of the cohort, while 27.7% received TACE. Most HCC patients in this setting present with advanced-stage disease and large tumor burdens, leading to low curative resection rates. Addressing deficiencies in specialized human resources, infrastructure, and policy gaps is critical to improving access to life-saving surgical and loco-regional interventions.