Comparison of Prognosis between Hepatic Resection and Transcatheter Arterial Embolization on Small Hepatocellular Carcinoma

Ryohei Izumi, Kohichi Shimizu, Masato Kiriyama, Tetsuo Hashimoto, Masaaki Urade, Takakazu Iyobe, Kazunori Iwasa, Hirotaka Masutani, Masao Yagi, Itsuo Miyazaki

Department of Surgery 2, School of Medicine, Kanazawa University

The outcome for 102 patients with hepatocellular carcinoma (HCC), whose diameter was less than or equal to 3 cm, Was analyzed according to the method of therapy. Fifty patients who underwent hepatectomy were divided into four groups: absolute curative hepatectomy (AC: n=12), relative curative hepatectomy (RC: n=19), relative noncurative hepatectomy (RNC: n=15) and absolute noncurative hepatectomy (ANC: n=4), which Were determined by the general rules for primary liver cancer of the Japanese Liver Cancer Study Group. Fifty-two patients were treated by transcatheter arterial embolization (TAE). TAE was performed once in 24 patients (TAE-0) and twice or more in 28 patients (TAE-TM). The survival curve for curative hepatectomy (AC+RC) was signficantly better than that for TAE, but there was no significant difference between the survival curves for noncurative hepatectomy (RNC+ANC) and TAE. There was a significant difference between survival curves for hepatectomy and TAE which were performed for HCC without intrahepatic metastasis, but no significant difference was noted between survival curves for hepatectomy and TAE which were performed for HCC with intrahepatic metastasis. The survival curve for TAE-TM was significantly better than that for TAE-O. The survival curve for AC was significantly better than those for TAE-O and TAE-TM. The survival curve for RC was significantly better than that for S-TAE, but a significant difference was noted only in the 4-year survival rate between RC and TAE-TM. Curative hepatic resection is necessary to achieve a good outcome when treating small HCC.

Key words
hepatocellular carcinoma, hepatic resection, transcatheter arterial embolization

Reprint requests
Ryohei Izumi Department of Surgery 2, School of Medicine, Kanazawa University
13-1 Takara-Machi, Kanazawa, 920 JAPAN

Accepted
April 17, 1991

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