Abstract

At present in Japan, over 80% of patients with hepatocellular carcinoma (HCC) are treated by nonsurgical methods because HCC characteristics, such as multicentric development and frequent association with liver cirrhosis, make surgery inadvisable. The 5-year survival rate in 258 patients with small HCC (less than 3cm in diameter) treated by percutaneous ethanol injection therapy (PEIT) was 51% and is comparable with that of surgical resection. Recurrence occurred in most cases within 5 years following PEIT. Thus, quarterly check-ups after the initial PEIT are particularly important to detect newly developed small HCC nodules. For nodular lesions of HCC more than 3cm in diameter, transcatheter arterial embolization (TAE) has been the treatment at choice but at present, TAE combined with PEIT for this group seem to show a better prognosis. For very advanced HCC, chemotherapy using a totally implantable injection port system showed a remarkable improvement in survival over the previous one-shot injection treatment.

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