Primary hepatic carcinoma. A review of thirty-seven patients.

Abstract Thirty-seven patients with primary hepatic carcinoma have been treated at the University of Kansas Medical Center. The peak incidence was in patients in the sixth decade. Weight loss, weakness, and epigastric pain were common clinical features which were present for an average of 7.5 months prior to diagnosis. Hepatic scanning has been a most important advancement in diagnosis and its value far exceeds that of liver function tests and needle biopsy. Early operation with open liver biopsy is desirable. Sixteen patients (43 per cent) had surgical exploration and seven (44 per cent) of the surgical group had hepatic resection. There were three hospital deaths. The five year survival rate of the operative group is 19 per cent. Three of four operative survivors (75 per cent) remain free of disease at ten years, thirty months, and eighteen months, respectively. Earlier diagnosis by hepatic scanning and the alpha-feto-globulin test may improve the resectability rate.