Primary hepatocellular carcinoma in patients with chronic hepatitis B virus infection.

The paper presents 66 hepatocellular carcinoma (HCC) patients (57 males, 9 females) with chronic hepatitis B virus (HBV) infection in the clinical, diagnostic and therapeutic aspects. In 60 cases, hepatic cirrhosis was the primary hepatic disease, in 5--chronic hepatitis, and in 1--neoplasm developed in morphologically normal liver. Forty out of 66 patients were HBsAg seropositive. In 96% of the cases, anti-HBc antibodies were detected. In 76% of the cases, the infection was subclinical. In all patients, neoplasm was diagnosed in the late, symptomatic stage of the disease. Okuda's classification was used to stage the disease. The following treatment methods were applied: surgical in 5 patients, embolization of hepatic artery with intra-arterial administration of cytostatics in 5, intravenous chemotherapy in 39, interferon alpha in lozenges in 15. In 44 patients, an objective response to treatment (according to WHO criteria) was achieved: in 5 (I and II Okuda's stage)--a complete response (CR) for the period of 0.5-4 years, in 2 (III Okuda's stage)--partial response (PR) with prolonged survival time up to 1 year, in 21--no change (NC). The average survival time of non-treated and treated patients was, respectively: in the I Okuda's stage 2.05 and 9.55 months, in stage II 1.36 and 7.36 months, in III stage 1.15 and 5.05 months. The differences in the average values are statistically significant. Only combined therapy, including both surgical and devascularization methods, applied to HCC patients results in achieving a long-lasting complete remission of the disease. Interferon alpha oral therapy improves the effects of the treatment.