Natural history and prognostic factors of primary hepatocellular carcinoma: study of 70 untreated patients.

We carried out a study of the clinical courses of 70 untreated patients with primary hepatocellular carcinoma (HCC) in order to evaluate their survival period and the prognostic factors. The median survival was two months. We evaluated ten variables of biochemical parameters and findings of hepatic scintigraphy. Among them, six variables were chosen by univariate analysis. They were serum bilirubin (cut-off value 3.0 mg/dl), alkaline phosphatase (150 IU/ml), aspartate aminotransferase (AST) (200 IU/ml), alanine aminotransferase (ALT) (50 IU/ml), reticuloendothelial (RES) dysfunction (grade 1) and multiplicity of space occupying lesions (SOL). Multivariate analysis identified three variables. The RES dysfunction and multiplicity of SOL by hepatic scintigraphy and bilirubin were considered as important prognostic factors. We found that the functional reservoir of the underlying liver and multiplicity of the origin of the tumor were the most important prognostic factors.