Sixty cases of primary hepatocellular carcinoma in one year. A preliminary appraisal

We studied all the 70 cases of liver cancer referred to us in 1988. Sixty (85.71%) were primary hepatocellular carcinoma (HCC), the other 10 (14.29%) were metastatic liver cancer. Of the 60 HCC, 48 were males and 12 females. Peak age incidence was between 20-40 years. Forty-five (75%) had tumours in both lobes. Of the remaining 15, seven had tumours in the right lobe while eight were in the left. More detailed assessment identified eight as Child's C. Seven (11.66%) had laparotomy, and two were inoperable. Three (60%) died shortly after resection, leaving two survivors. One of the survivors lived for 24 months, and the other had recurrent tumour after 26 months. The majority had cirrhosis of the liver, were positive for markers of hepatitis B virus, and showed elevated serum alpha fetoprotein (AFP). Palliative treatment was disappointing, and all were dead within 15 months. Prognosis of HCC in our environment is poor. Considering the advances made in liver surgery in recent years, our mortality and morbidity figures can improve. Notwithstanding, preventive measures should be intensified.