الفهرس 
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Abstract
HCC is the most common primary malignant tumour of the liver. HCC accounts for 90% of primary liver cancers and causes at least 1 million deaths worldwide per year. It is the 5th most common cancer in the world and the 4 in annual mortality rare. The annular mortality rare from the HCC is virtually the same as its annular incidence, which attests to its rapid course, and grave prognosis.
In this study a total of 3000 Egyptian patients with hepatocelluar carcinoma were registered at Nasser institute and October 6 university and hepatology institute of cairo between the year of 2000 to 2010 their files were studied to show that only 508 files were with complete data while the rest were deficient in essential data and also there were no data records found before theses dates
Several factors were considered as age , sex, presence of viral hepatitis, tumor size, site and number, and underling factors of liver disease as ascites, encephalopathy, INR, Serum albumin, and serum bilirubin
The study was based on the prevalence of viral hepatitis among Egyptian patients with hepatocellular carcinoma showing that there were higher prevalence among males (82.68%), and female (17.32%) with 64% in the age group between 40-59.
There was higher prevalence of HCV +ve (82.68%) followed by HBV +ve (3.5%) and cooinfection (0.6%) .
71.46% single hepatic focal lesion, 8.66% had 2 hepatic focal lesions and 19.9% had multiple hepatic focal lesion. 66.14 % of these hepatic focal lesion were in the right lobe, 17.52% were in left lobe and 16.34% were in both lobes. The mean size was (4.6±2.48)
It is worth mentioning that the presence of liver cirrhosis paves the way for risk factors making HCC almost always inevitable.
Agricultural and industrial pollutant exposure has proved to be worthy of a high rank among the conventional risk factors of HCC.
Smokers, alcoholics and drug addicts proved to be at a relatively higher risk of developing HCC than other individuals abstaining from such hazardous habits.
AFP levels alone are controversial regarding the diagnosis and follow-up of HCC. However, when radiological imaging by U/S and/or C.T. is correlated with AFP levels diagnosis and follow-up become more conclusive.
Screening often permits the diagnosis of HCC at a stage when it is small and limited to the liver. Such tumours are frequently amenable for resection, or to other local treatment measures, resulting in a prolonged disease-free survival.
Surgical resection remains the only potentially curative treatment of hepatic malignancies. Unfortunately, most primary hepatic malignancies are unresectable. Approximately 35% of patients with HCC have resectable disease at the time of diagnosis. Patients with HCC are often poor surgical candidates because of the lake of hepatic reserve resulting from coexisting liver cirrhosis, the presence of multiple lesions at the time of diagnosis, or proximity of tumour to key vascular jar biliary structures, additionally, because of the underlying cirrhosis, this patients are high risk for the development of new tumour nodules.
Radiofrequency thermal ablation (RFA) is a more recently developed method for local tissue ablation. In this technology radiofrequency energy at a frequency of 400 to 500 kHz is delivered into the tissues. A resistive heating occurs as a result of the vibrations of the electrons within the tissues caused by this high frequency current. Once cells are heated above 50°C, their cell membranes melt and fuse, and with continuous heating, proteins denaturation and irreversible cell death occurs.
Biologic therapy is a model of cancer treatment that produces antitumor effects primarily through action of natural host defense mechanism.