Primary carcinoma of the liver: clinical course and therapeutic results

A Finnish series of 53 patients with primary carcinoma of the liver has been examined with a view to establishing the clinical course, the therapeutic results, and the factors which might influence the prognosis. Four tumors were resected, with one 6-year survival. All patients with no effective treatment were dead within 1 year from diagnosis. Thirty-seven nonresected patients with primary liver carcinoma were treated with chemotherapy and/or hepatic irradiation with mean survival time of 9.1 months after diagnosis. The best palliation in these patients was achieved by the combination treatment of chemotherapy and hepatic irradiation; the mean survival time was 13.8 months and, considering only the responders, 18.3 months. The laparotomy finding of 46 cases revealed that 67% of patients were without extrahepatic metastases of primary liver carcinoma at the time of diagnosis. At autopsy that figure was 44%. These data demonstrate that primary liver carcinoma is surprisingly often localized in the liver, but yet survival in these patients seems to be only occasionally favorably influenced by recent therapies, except hepatic resection, which remains the treatment of choice when feasible. Perhaps for primary carcinoma of the liver, the combination treatment of chemotherapy and hepatic irradiation gives better palliation than either one of these therapies alone.