Choice of Appropriate Treatment for Hepatocellular Carcinoma Judged from Both Tumor and Clinical Stage

Yo Sasaki, Shingi Imaoka, Terumasa Yamada, Osamu Ishikawa, Hiroaki Ohigashi, Hiroshi Furukawa, Toshiyuki Kabuto, Masahiro Hiratsuka, Masao Kameyama, Takushi Yasuda,
Kohei Murata, Hiroshi Nakano and Hiroshi Kasugai^*

Departments of Surgery and Gastroenterology^*,
Osaka Medical Center for Cancer and Cardiovascular Diseases

Until December, 1997, 654 HCC patients received hepatic resection (A), 109 had percutaneous transhepatic ethanol injection therapy (PEIT)(B), and 701 had transcatheter arterial embolization therapy (TAE)(C). The long-term outcomes of the patients who received the therapies were compared at the same tumor and clinical stages. Among the stage I HCC patiets with clinical stage I, the 5- and 10-year survivals of A were 76% and 50%, and those of B were 46%, 0%, respectively (A to B; NS). In stage I HCC patients with clinical stage II, the 5- and 10-year survivals of A were 61%, 10%, those of B were 47%, 35%, and those of C, 27%, 0%, respectively (A to C, B to C; p<0. 05, A to B; NS). Of stage II painets, the 5- and 10-year survivals were 57%, 33% n A, 0%, 0%in B, 19%, 0% in C (A to B, C; p<0. 0001). In stage III patients with both clinical stages, although the 5-year survival of A was significantly better B, no significant differences were recognized about 10-year survivals. In the comparison of the 5-year survivals of the stage IV patients who had 3 or less tumors with less than 3 cm in size, the 5-year survivals were 53% in A, 66% in B, 26% in C, resepectively (A to B to C; NS). Hepatic resection showed the better outcome than the other treatment groups in stage I, II and III patients with relatively good liver function. The patients in stage II are the most suitable for hepatic resection. In the stage IV patients with small and a few HCCs, PEIT may be recommended as the first choice therapy.

Key words
indication of hepatic resection for hepatocellular carcinoma, tumor stage and clinical stage of hepatocellular carcinoma, choice of treatment for hepatocellular carcinoma

Reprint requests
Yo Sasaki Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511 JAPAN

Accepted
January 27, 1999

To read the PDF file you will need Abobe Reader installed on your computer.