TREATMENT OF PRIMARY LIVER-CANCER

Objective: To evaluate treatment of patients with primary liver cancer . Design: Prospective protocol including subsets of randomised studies . Setting: University hospital, Sweden. Subjects: 123 patients with pr imary liver cancer. Interventions: 64 patients underwent hepatic resec tion, 25 were included in a trial of adjuvant chemotherapy. 24 further patients whose tumours were not resectable were included in a trial o f intra-arterial infusion of doxorubicin. Main outcome measures: Survi val and postoperative morbidity. Results: The median survival time for patients who had had resections was II months (range 0-111). Twelve p er cent survived more than 5 years. No prognostic factor had any signi ficant effect on outcome. The postoperative mortality was 11% (7/64). The patients allocated to adjuvant chemotherapy survived a median of 1 0 months (range 1-47) and the controls 29 months (range 8-111) (p = 0. 04). Patients with unresectable liver cancer treated with intra-arteri al doxorubicin lived no longer than untreated controls (median 8 month s (range 1-56) compared with 7 months (range 1-28)). Conclusions: Trea tment of patients with primary liver cancer is still an unsolved probl em. Adjuvant chemotherapy with doxorubicin had no beneficial effect on survival.