Treatment of primary liver cancer -- with special reference to the east part of China.

Despite the poor prognosis of primary liver cancer (PLC), encouraging progress in treatment of PLC has been observed in China. It is mainly due to the discovery of "subclinical" and small hepatocellular carcinoma in mass screening by alphafoetoprotein (AFP) detection that the role of surgical resection, the most effective therapeutic modality, has become greater. When mass survey patients were compared with clinical cases, percentage of resection in the whole series was three times higher (56.1% vs. 17.7%), operative mortality further decreased (2.7% vs. 5.1%), and 3-year survival after resection double that of the clinical group (61.6% vs. 26.0%). In an attempt to further increase the resectability rate, new techniques such as bloodless operation (total vascular occlusion with or without hypothermic perfusion) have been employed. Cryosurgery as well as radiotherapy was recognised as effective approaches for the control of localized tumour. A combination of various therapeutic modalities including hepatic artery perfusion, hepatic artery ligation, radiotherapy, chemotherapy, Chinese traditional medicine and immunotherapy was helpful in improving the ultimate outcome of PLC. Early detection, radical resection and combination treatment are some of the important aims to reduce the mortality rate of PLC.