Adjuvant oral chemotherapy to prevent recurrence after curative resection for hepatocellular carcinoma

Adjuvant oral chemotherapy was studied in 67 patients with stage II hepatocellular carcinoma who underwent curative resection between May 1988 and December 1990. Patients were stratified into two groups according to preoperative liver dysfunction: 55 had stage I disease (mild dysfunction) and 12 had stage II (moderate dysfunction). A randomized controlled study of postoperative oral administration of 1-hexylcarbamoyl-5-fluorouracil (HCFU) was conducted in each group. From October 1994 HCFU administration was suspended because of side-effects in nine patients with stage I liver dysfunction and in three with stage II dysfunction who had received the drug for more than 4 weeks. Cumulative survival and recurrence-free survival rates of patients with stage I disease in the treatment group were higher (P = 0·08 and P = 0·04 respectively) than those in the control group. However, in patients with stage II disease no significant difference was observed (P = 0·77 and P= 1·0 respectively). This study suggests that the potential benefits of HCFU on tumour recurrence should be weighed against the risks of adverse reactions in patients with mild liver dysfunction.