Sixty‐three patients with hepatocellular carcinoma associated with cirrhosis received various kinds of treatment at our clinic during the past 21 years. Of these, 35 patients who underwent hepatic resection were divided into a large tumor group (tumors more than 5 cm in diameter) and a small tumor group (tumors less than 5 cm in diameter), and the operative results of both groups were studied. There was a difference in the average ages between the 2 groups (p <0.05), but there was no difference in the duration of illness or laboratory data. The resectability rate of the liver in 17 patients with small tumors was 89% and was significantly higher than that of 41% in 18 patients with large tumors (p<0.005). The overall operative mortality rate was 14% for both groups. Patients with tumors over 3 cm already exhibited the histological findings seen in advanced cancer. Cumulative 3‐year survival rates of the large and small tumor groups were 0% and 53%, respectively, and there was a significant difference in survival curves between the 2 groups (p<0.005). The above results suggest that hepatic resection for patients with small tumors is effective as a treatment for hepatoma associated with cirrhosis.

This study was performed to clarify the promoting effects of primary or secondary bile acid load on the occurrence of cholangiocarcinoma, using Syrian golden hamsters. These hamsters received subcutaneously diisopropanolnitrosamine (DIPN) once weekly for 10 weeks, and simultaneously were given a standard pellet diet (control group) containing taurocholic acid (TCA group) or deoxycholic acid (DCA group). The rates of cholangiocarcinoma at 20 weeks were 23% in the control group, 60% in the TCA group and 59% in the DCA group. There were significant differences between the control and the TCA or DCA groups (p < 0.05). The rates of proliferation of bile ductules or hyperplasia of the bile duct epithelium and the bromodeoxyuridine labeling indices of bile duct epithelial cells were high in both groups treated with bile acids, compared with those in the control group. Regarding the composition of bile acids in the intraductal bile, the TCA and DCA groups revealed a decrease in primary bile acids and an increase in DCA. These results suggest that both TCA and DCA given orally promote the occurrence of DIPN-induced cholangiocarcinoma.

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Forty-five patients with inoperable cancer of the liver were treated by the one shot administration of 15-40 mg of Mitomycin C into the hepatic artery, either by the superselective or by the selective ofie shot method. Fourteen of the patients had primary cancers of the liver, and 31 had metastases to the liver from primary cancers of the stomach, or from the colorectal or other organs. Subjective symptoms improved in 7370, and objective signs improved in 60%.Nineteen patients who received this treatment more than twice showed a mean survival time of 10 months and a 50% survival time of 7.8 months. Therapeutic effects of the selective one shot method were recognized mostly in patients with tumors which were rich in vessels. However, a fairly good result was obtained using the superselective one shot method, even in patients with tumors having relatively few vessels.Cancer 41:1720-1727, 1978.HE SURVIVAL TIME OF PATIENTS WITH INOP-T erable cancer of the liver has been known to be short. Purves et a1." showed that the mean survival time of 93 patients with primary cancers of the liver was 75.9 days, and Jaffe et al.13 reported that a 50% survival time of 390 patients with metastatic cancers of the liver was 75 days. In our previous report,I4 a 50% survival time of 53 patients with inoperable primary or metastatic cancers of the liver was 2.5 months.The therapy for these patients recently has been conservative, including chemotherapy, radiotherapy and other methods. Local administration of antineoplastic agents via the arterial route was performed by Klopp et for the first time in 1950. Thereafter, this intra arterial continuous infusion of antineoplastic agents has been carried out in patients with inoperable cancers of the 1iver.3--7.9~18~24 Recently, the one shot method, in which massive doses of antineoplastic agents are given by one shot, has been widely performed inThe purpose of