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 primary liver cancer. Interventions: 64 patients underwent hepatic resection, 25 were included in a trial of adjuvant chemotherapy. 24 further patients whose tumours were not resectable were included in a trial of intra-arterial infusion of doxorubicin. Main outcome measures: Survival and postoperative morbidity. Results: The median survival time for patients who had had resections was II months (range 0-111). Twelve per cent survived more than 5 years. No prognostic factor had any significant effect on outcome. The postoperative mortality was 11% (7/64). The patients allocated to adjuvant chemotherapy survived a median of 10 months (range 1-47) and the controls 29 months (range 8-111) (p = 0.04). Patients with unresectable liver cancer treated with intra-arterial doxorubicin lived no longer than untreated controls (median 8 months (range 1-56) compared with 7 months (range 1-28)). Conclusions: Treatment of patients with primary liver cancer is still an unsolved problem. Adjuvant chemotherapy with doxorubicin had no beneficial effect on survival.