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Results of surgical and nonsurgical treatment for small‐sized hepatocellular carcinomas: A retrospective and nationwide survey in Japan
Author(s) -
Arii Shigeki,
Yamaoka Yoshio,
Futagawa Syunji,
Inoue Kyoichi,
Kobayashi Kenichi,
Kojiro Masamichi,
Makuuchi Masatoshi,
Nakamura Yasuni,
Okita Kiwamu,
Yamada Ryusaku
Publication year - 2000
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1053/jhep.2000.20456
Subject(s) - medicine , hepatocellular carcinoma , hccs , percutaneous ethanol injection , stage (stratigraphy) , gastroenterology , percutaneous , liver cancer , retrospective cohort study , group a , surgery , urology , paleontology , radiofrequency ablation , ablation , biology
Hepatic resection (HX), percutaneous ethanol injection (PEI), and transcatheter arterial embolization (TCAE) have all been used in the treatment of patients with small‐sized hepatocellular carcinomas (HCCs). However, the indications for these therapeutic modalities remain unclear. Therefore, the first step to minimize the debate on these indications is to review the standard results from each treatment based on an extensive survey. The participants in this study were patients with HCCs less than 5 cm in diameter who were enrolled in The Liver Cancer Study Group of Japan. The survival rates in the HX (n = 8,010), PEI (n = 4,037), and TCAE (n = 841) groups were calculated in relation to the number of tumors and the clinical stage. In the clinical stage I cases with a solitary tumor less than 2 cm in diameter and in all clinical stages with a solitary tumor greater than 2 cm and in the clinical stage II cases with 2 tumors greater than 2 cm, the HX group showed higher survival rates than the nonsurgical groups. The HX group had a higher male/female ratio and a younger mean age than the PEI or TCAE group. The ratio of HBs antigen‐positive cases/hepatitis C virus antibody‐positive cases in the PEI group was lower than that in the corresponding HX group. In contrast, the PIVKA‐II values in the HX group tended to be higher than in the PEI group. In conclusion, these findings will provide useful information for selection of a therapeutic modality for small‐sized HCCs.