<p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p> <p>From 1968-1985 a series of thirty-seven patients with primary hepatocellular carcinoma was collected
from the tumor registry of the Fairfax County Hospital, in the metropolitan Washington, D.C. area.
These patients were found to have a mean age at diagnosis of sixty-two (males) to sixty-six (females).
Thirty per cent of patients were previously cirrhotic and nineteen per cent had a history of viral
hepatitis. There were no patients with documented birth control pill or steroid use. The most common
presenting symptoms were anorexia and right upper quadrant pain. Liver-spleen scan was the most
commonly used diagnostic study, but by the 1980's CT scanning was usually diagnostic. Both alkaline
phosphatase and serum glutamyloxalotransferase were reliably elevated in twenty-six of twenty-eight
and twenty-one of twenty-four patients respectively. Forty-eight per cent of patients with tumor
histology reprted had multicentric tumors, thirty-eight per cent had nodular tumors, and fourteen per
cent had diffuse disease.</p> <p>Survival was as dismal in this as in other studies with a mean of seventy-nine days. No significant
difference was noted between cirrhotic and non-cirrhotic patients. Chemotherapy and radiation therapy
did not significantly impact upon survival.</p> <p>Finally, a cohort analysis was done and a possibly significant peak in incidence of primary
hepatocellular carcinoma was seen in men born from about 1911 through 1920. The authors noted that
these males were in the group of draft eligible persons for World War II and questioned a link between
veteran status and later development of HCC.</p>
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HPB Surg. 1990; 3(1):11-19