The natural history of primary liver cell carcinoma: a study of 89 untreated adult Nigerians.
A Nigerian series of 890 patients with primary liver cell carcinoma, seen during the recent three years, has been examined with a view to establishing the natural history of the tumour in untreated cases. There were 60 males and the mean age of all the patients was 50 years. Hepatitis B surface antigen was positive in 70 pc of tested patients and there were higher pathologic levels of aflatoxins in these patients when compared to normal controls. Liver cirrhosis was associated with 81 pc of patients. Alcohol and smoking were unlikely to be aetiologically important in these patients. The macroscopic type of tumour was mainly diffusely nodular and the commonest microscopic pattern was the characteristic trabecular pattern. Metastases were present in 52 pc of the patients and were mainly to the lungs. Due to late presentation and underlying cirrhosis, most patients were critically ill with high incidence of ascites, jaundice and hepatic precoma. The mean survival time of all patients was six months after onset of the initial symptoms to death and only three weeks after admission to death. The major causes of death were advanced cancer in 78 pc, hepatic failure in 48 pc and rupture of tumour, 39 pc. These observations clearly show that the prognosis of liver cancer is dismal in this environment, as elsewhere. Medical education on earlier presentation in hospital and early operative removal of the tumour should be emphasised. It is suggested that an attempt through immunisation should be employed to reduce the incidence of liver cancer in the population.
Olubuyide
I O
IO
Department No. 19, King Khalid University Hospital, Riyadh, Saudi Arabia.
D000293:Adolescent; D000328:Adult; D000348:Aflatoxins / Q000097:blood; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006785:Hospitals, University; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009549:Nigeria; D015996:Survival Rate
D000348:Aflatoxins; D006514:Hepatitis B Surface Antigens