Subclinical primary liver carcinoma

From 1976 to 1984, 30 cases of asymptomatic primary liver cancer (subclinical primary liver cancer) have been treated in our hospital. The most important approaches used to uncover subclinical primary liver cancer were 1) the use of alpha-fetoprotein (AFP) monitoring in patients with liver disease; 2) the use of an AFP survey among high-risk area populations; and 3) X-ray examination of the diaphragm and sonography examination. The resectability rate of this series was 50%. The 3 and 5 year survival rates after hepatectomy were 62.5 and 57.1%, respectively. Hepatic arterial ligation combined with irradiation for the nonresectable cases had a better result. We discuss here the approaches and the diagnostic criteria of subclinical primary liver cancer.