Unresectable hepatocellular carcinoma: a prospective controlled trial with tamoxifen

F. Farinati, M. Salvagnini, N. de Maria, A. Fornasiero, M. Chiaramonte, Lorenzo Rossaro, R. Naccarato

Research output: Contribution to journalArticlepeer-review

101 Scopus citations

Abstract

The liver is an estrogen responsive organ. Clinically, estrogens may play a role in the induction of liver tumors and, experimentally, estrogens are involved in the control of hepatocyte proliferation. The results of a prospective controlled clinical trial using an anti-estrogen, tamoxifen, in patients with unresectable hepatocellular carcinoma (HCC) are presented below. Thirty-eight consecutive cirrhotics with HCC were allocated to either 30 mg/day tamoxifen or no treatment. The two groups of patients were matched for mean age, male/female ratio, Child-Pugh risk group, approximate tumor volume (US and/or CT scan) and etiology of the underlying cirrhosis. The drug appeared to have no side effects. Survival was significantly prolonged in tamoxifen-treated patients with 22% (vs. 5%) survival at 12 months. No differences were observed between males and females or alcoholic and non-alcoholic cirrhosis. In 53% of tamoxifen-treated patients the levels of α-fetoprotein dropped and, in this subgroup, survival was further prolonged. Tumor volume, lactate dehydrogenase (LDH) and alkaline phosphatase slowly increased, suggesting a slower, but continuous, progression of the disease. In conclusion, anti-estrogen treatment appears effective in the palliation of unresectable or otherwise unbeatable HCC. A reduction in α-fetoprotein levels appears to be a favorable prognostic index.

Original languageEnglish (US)
Pages (from-to)297-301
Number of pages5
JournalJournal of Hepatology
Volume11
Issue number3
DOIs
StatePublished - 1990
Externally publishedYes

ASJC Scopus subject areas

  • Gastroenterology

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