The epidemiology of primary liver cancer in a West German population: the Saarland

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Abstract
The present study is based on the data of 321 cases of primary liver cancer (PLC); 225 hepatocellular carcinomas (HCC), 54 cholangiocellular carcinomas (CCC) and 35 unclassified carcinomas autopsied between 1963 and 1982 or reported to the Saarland Cancer Registry between 1967 and 1981. The age standardized incidence rate for the Saarland was determined as 1.1. We noticed an increase in incidence for both HCC and CCC. The HCC rise was based on a significant (p<0.05) increase for women. The incidence maximum in the successive birth cohorts is shifting into younger age groups. The highest rates were observed in men and women born between 1900 and 1909. The regional distribution of PLC in the Saarland shows an accumulation in the urban areas. The mean survival time from diagnosis to death was 3.1 months. Prognosis was only influenced by the grade of differentiation. 88.3% of the HCC, but only 28.6% of CCC occurred in cirrhotic livers. Orcein staining of 55 liver specimens showed evidence of previous HBV infection in 12 out of 38 cases of HCC (31.6%) and no evidence of HBVB in the 17 cases of CCC studied.