Original Articles
Copyright ©The Author(s) 1999. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 15, 1999; 5(6): 483-487
Published online Dec 15, 1999. doi: 10.3748/wjg.v5.i6.483
Hepatocellular carcinoma in central Sydney: a 10 year review of patients seen in a medical oncology department
Desmond Yip, Michael Findlay, Michael Boyer, Martin H. Tattersall
Desmond Yip, Michael Boyer, Department of Medical Oncology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
Michael Findlay, Wellington Cancer Centre Private Bag 7902, Wellington, New Zealand Email. michael.findlay@wnhealth.co.nz
Martin H. Tattersall, University of Sydney, Camperdown NSW, Australia
Desmond Yip, male, born on 1966-01-28 in Sydney, Australia. Graduated from Sydney University in 1989, trained in medical oncology, now working in clinical research with an interest in gastrointestinal malignancies and novel therapies. Currentlya clinical research fellow, Department of Medical Onco logy, Guy¡äs Hospital, London, United Kingdom.
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Michael Findlay, Wellington Regional Oncology Unit, Wellington Hospital, Private Bag 7902, Wellington, New Zealand. woncmf@wnhealth.co.nz
Telephone: +64-4-3855999 Fax: +64-4-3855984
Received: August 10, 1998
Revised: September 11, 1998
Accepted: April 2, 1999
Published online: December 15, 1999

AIM: To report a single Australian oncology unit’s experience with the management of patients with hepatocellular carcinoma (HCC), in the context of a literature review of the current management issues.

METHODS: Retrospective case record review of 76 patients with diagnosis of HCC referred to the unit between 1984 and 1995.

RESULTS: Sixty-three patients had adequate records for analysis. Thirty-six (56%) were migrants with half from Southeast Asia. Twenty-four p atients had a documented viral aetiology. Nine (14%) of 51 patients with pathological confirmation of HCC had normal alpha-fetoprotein levels. Median survival of the 20 patients managed palliatively was 5 weeks compared to 16 weeks for the cohort overall. Surgery in 16 patients rendered all initially disease free with a median survival of 88 weeks. Chemoembolisation induced tumor responses in 5 of the 11 patients so treated. Systemic chemotherapy and tamoxifen treatment caused tumor response in two of 12 and one of 25 respectively.

CONCLUSION: Prolonged survival of patients with HCC depends on early detection of small tumors suitable for surgical resection. Other active t reatments are palliative in intent and have limited success. In addition to tumor response and survival duration, the toxicities of therapies and the overall quality of life of patients need to be considered as important outcomes. Viral hepatitis prevention and screening of individuals at risk are strategies that are important for HCC management in communities where the disease is endemic.

Keywords: carcinoma, hepatocellular, liver neoplasms, survival/rate, Australia