Prognosis of Primary Hepatocellular Carcinoma

Abstract

Prognosis of 600 consecutive patients with hepatocellular carcinoma was analyzed in relation to treatment. They were divided into three stages based on four parameters of advanced disease: ascites, tumor greater than 50% of the two-dimensional size of the liver, serum albumin below 3 gm per dl, and serum bilirubin above 3 mg per dl. Stage I had none of these signs; Stage I1 one or two signs, and Stage 111 three or all signs. Of 600 patients, 98 had resection, 333 had nonsurgical treatment (1 58 treated by intraarterial chemotherapy, 94 systemic chemotherapy, 77 transcatheter embolization, and 4 others) and 169 no treatment.The median survival of untreated patients was only 1.6 months from diagnosis, and no untreated Stage I11 patient lived more than 3 months; there was a median survival of 0.7 month. Surgically treated patients lived significantly longer than nonsurgical patients of comparable stages; median survival was 19.6 months in the former and 2.8 months in the latter. Whereas Stage I patients did fairly well without treatment, chemotherapy significantly prolonged survival of patients of Stages I1 and 111. These results suggest that early diagnosis and hepatic resection improve prognosis in patients with hepatocellular carcinoma in the areas where this cancer frequently emerges unicentrically. In view of the generally poor prognosis, liver transplantation is recommended when resection is not possible or indicated, and before extrahepatic metastasis occurs. Hepatocellular carcinoma (HCC) is the most common form of primary hepatic carcinoma and represents one of the most malignant solid tumors in terms of prognosis. It is followed in decreasing frequency by cholangiocarcinoma, mixed hepatocholangiocarcinoma, hepatoblastoma, angiosarcoma, etc. (1). There are regional differences in the clinical presentation and natural history. Advanced cirrhosis is uncommon, and the liver is often free of cirrhotic changes in South African blacks as contrasted by more frequent cirrhosis in other parts of the world where patients may present as a case of cirrhosis and HCC emerges during the follow-up (2). Despite these differences, the basic clinical features and generally poor prognosis are the same regardless of race and place. In this study, we evaluated the prognosis of patients with HCC seen and treated at major hospitals in Japan. These findings should be applicable to other parts of the world. PATIENTS AND METHODSSix hundred consecutive patients with unequivocal HCC who were admitted and followed at the First DeAddress reprint requests to: Kunio Okuda, M

Prospective Study on the Survival of HCC Patients Treated with Transcatheter Arterial Lipiodol Chemoembolization

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Place of Cryosurgery in the Treatment of Malignant Liver Tumors

“…The local recurrence rate for HCC was 0% for a mean follow-up of 18.4 months (range, [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Table 5.…”

Transcriptional profiling on chromosome 19p indicated frequent downregulation of ACP5 expression in hepatocellular carcinoma

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