Background & objective: Progress has been made in the field of early detection and early treatment of primary liver cancer (PLC), but many PLC patients remain unresectable, because their tumors are advanced or coexist with liver cirrhosis. Even if the tumor can be resected, the recurrent rate is more than 60%. This study aimed to investigate the efficacy of comprehensive therapy of PLC to improve the outcome.
Methods: A retrospective analysis of 607 patients with PLC received comprehensive treatment in Affiliated Tumor Hospital, Guangxi Medical University from 1985 to 2001. Among them, 423 cases were treated with various modes of hepatectomy: 134 with irregular hepatectomy, 95 with local radical resection, 123 with regular liver lobectomy or liver segment resection, 54 with semi-hepatectomy or more, 17 with hepatectomy combined with section of other organ. The other 184 nonresectable cases were treated with various combinations of therapy, such as ligation of hepatic artery, microwave coagulation, inter tumor injection of ethanol, cryosurgery, radio-frequency (RF), and intraperitoneal chemotherapy.
Results: 69.7%(423/607) of the whole group received liver resection, the overall mortality rate within one month after operation was 1.2%(5/423), and the 3-, 5-, 10-year survival rates were 42.7%(218/511), 37.5%(123/328), and 26.5%(26/98), respectively. For the resection group,the 3-, 5-, 10-year survival rates were 57.2%(203/355), 51.3%(118/230), and 35.3%(24/68), respectively. For the nonresectable group, the 3-, 5-, 10-year survival rates were 9.6%(15/156), 5.1%(5/98), and 6.7%(2/30), respectively.
Conclusion: Surgery-predominant comprehensive therapy is effective modality for resectable PLC. Postoperative individualized comprehensive treatment can prevent tumor recurrence and improve postoperative effect.