【摘 要】
：
Hepatocellular carcinoma (HCC) develops in damaged liver such as fibrotic or cirrhotic liver and is characteristic of recurring in the liver by intra-hepatic metastasis or multi-centric occurrence.The
【机 构】
：
Department of Gastro-enterological Surgery Dokkyo Medical University Tochigi Japan
【出 处】
：
BIT‘s2nd Annual World Cancer Congess-2009 (2009第二届癌症大会)
论文部分内容阅读
Hepatocellular carcinoma (HCC) develops in damaged liver such as fibrotic or cirrhotic liver and is characteristic of recurring in the liver by intra-hepatic metastasis or multi-centric occurrence.Therefore the treatment of HCC presents difficult clinical problem.Treatment modality is selected on the basis of tumor condition and liver function.In this presentation, I will focus on the hepatic resection combined with chemotherapy and transcatheter arterial embolization (TAE).When ICG 15 was smaller than 30%, anatomical resection including systematic subsegmentectomy was indicated, while non-anatomical resection was applied to patients with worse liver function.Under the guidance of ultrasound, the portal branch was punctured and indigocarmine was infused to stain the area, which was subsequently resected under Pringles manuever.This procedure aims at removing possible intrahepatic metastatic lesions and contributes to prolonging 5-year disease-free survival rate compared with non-anatomical resection (28.5 % vs 14.1%).Nevertheless, postoperatively HCC recurrs frequently.For controlling the intrahepatic recurrences, TAE is employed, while chemotherapy consisting of 5-FU (500 mg/m2 for 14 days) and interferon-alpha (5 MU 3 times/week for 4 weeks) is instituted in patients with extra-hepatic metastasis.By employing this multidisciplinary treatment, 60.1% of 5-year overall survival rate and 19.2% of disease-free survival rate were obtained in 414 patients.This multidisciplinary treatment is mandatory for treating HCC.
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