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Background and study aims Hepatocellular carcinoma (HCC) with extrahepatic metastasis has been studied, however, data from the Middle East remain scarce. In this study, we assess epidemiology of HCC in Qatar, and identify predictors of the metastatic behaviour. Patients and methods All newly-diagnosed HCC patients on top of liver cirrhosis between 2011 and 2015 were included in the study. Results A total of 180 patients met our inclusion criteria. The mean age was 58.8 ± 10.5 years with a mean follow-up of 1.0 ± 1.1 years. There were 150 male patients and HCV was the most common cause of liver cirrhosis 108 (60%), and 22 (12.2%) patients were classified as Child-Pugh class C. The overall survival of 51.1%, and 47 (26%) had at least one extrahepatic metastasis at the time of diagnosis. Single site metastasis was diagnosed in 10 patients, whereas 37 patients had multiple sites metastases. We compared patients who had metastases with patients who did not have metastasis at the time of diagnosis of HCC regarding several variables, and analysis revealed that tumour diameter larger than 5 cm (OR = 6.10, 95% CI = 1.85–20.12) (p = 0.003), and bilobar liver involvement (OR = 5.49, 95% CI = 1.10–27.30) (p = 0.037) were independent predictors of metastatic behaviour of HCC. Conclusion The incidence of HCC is rising in our population, extrahepatic metastasis is no longer rare and tumours larger than 5 cm and bilobar involvement are determinants of the extrahepatic metastasis.

Cancer is a major public health problem all over the world. Monitoring the evolution of the cancer burden in the State of Qatar is of great value but has never been explored in depth.The aim of the study was to determine the incidence patterns of cancer cases, assess trends during the period 1991 - 2006 and make comparisons with other countries.This was a retrospective cohort study based on the Cancer disease registry of Al Amal Cancer hospital, State of Qatar, from 1991 - 2006. All Qataris and non-Qataris, males and females, who were diagnosed with any type of cancer were included in this study. The diagnostic classification of definite cancer cases was made according to the International Classification of Disease 10th revision (ICD-10).A total of 5,825 cancer cases were registered in Qatar during the period 1991 - 2006 with 56.7% in males and 43.3% in females, 35.6% in Qataris and 64.4% in non-Qataris. Incidence rates per 100,000 population showed that lung (5.9), lymph node (5.9), bone marrow (4.1) and connective tissue (3.9) were the top major cancers in men. In women, breast (30.1), genital organs (9), lymph node (6.8), rectum (6.1) and thyroid (5.7) cancers were the leading cancers. There was a sharp rise in the total number of cancer cases during the period 2002-2006 of 57.1% compared to the period 1991-1996. The incidence rate of cancer cases increased with increasing age in all cancer types except for breast cancer in women above 65 years old. During the study period, the five most common cancers among women were different from those in men. The incidence rate per 100,000 population of all cancer types in Qatar (63.1) was remarkably lower than the other Middle East countries and the UK.Cancer is an important public health problem in Qatar, with increase in incidence with age. Incidence rates of all cancers were higher across all age groups of women compared to men. Lung cancer was the most frequent cancer diagnosed in men and breast cancer in women. More epidemiological studies are now required to elucidate the patterns of cancer and related risk factors.