Hepatocellular Carcinoma in Keio Affiliated Hospitals : Diagnosis, Treatment, and Prognosis of this Disease

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概要

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• We have retrospectively investigated patients with hepatocellular carcinoma (HCC) (912 cases) treated in the Affiliated Hospitals of Keio University (the Keio Association for the Study of Liver Diseases: KASLD) and here we review the recent diagnosis and treatment of HCC. HCC is a major cause of death in Japan and a major etiology of this disease is chronic viral infection such as hepatitis C virus (HCV) and hepatitis B virus (HBV). Screening of HCC by imaging studies and measurement of serum tumor markers successfully prolonged survival of the patients in Japan. The prognosis of this disease has been determined by both tumor factors and degree of liver function, and its staging is usually established with a recent system such as Japan Integrated Staging Score (JIS). The 5-year survival rate of JIS stage 0, 1, 2 and 3 were 68.3%, 51.9%, 25.8% and 16.6%, respectively in our cohort. Multivariate analysis using Cox proportional hazard models showed that age (>65), HCV infection, tumor number, TB (>1.0), AFP (>20) and PIVKA-II (>40) were significant factors affecting survival among the entire patients. Major treatment strategies are hepatic resection, radio frequency ablation and transarterial chemo-embolization, but alternative treatments such as radiation, chemotherapy, and their combination have been used to reduce tumor sizes resulting prolongation of the survival or maintenance of patients quality of life, while liver transplantation has not been popular in Japan. However, the overall survival continues to decrease from year to year, and does not show a plateau phase in Kaplan-Mayer curve. These results suggest that the best way to improve survival can be achieved by prevention of the disease. Antiviral therapies have decreased the incidence of HCC, indicating that treatment for chronic hepatitis is the best way to prevent HCC development at present.

• The Keio Journal of Medicineの論文
• 2009-09-01

著者

• HIBI Toshifumi

  Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Ke

• Suzuki Hiramitsu

  群馬大学 衛生学

• TADA Shinichiro

  Department of Internal Medicine, School of Medicine, Keio University

• Masuda Tetsuya

  Nihon Kohkan Hospital

• Hibi Toshifumi

  Division Of Gastroenterology Department Of Internal Medicine Keio University School Of Medicine

• Hibi Toshifumi

  Division Of Gastroenterology And Hepatology Department Of Internal Medicine Keio University School O

• MASUDA Tetsuya

  Department of Internal Medicine, School of Medicine, Keio University

• SAITO Hidetsugu

  Inaida Research Center for Anti-aging Medicine in Hepato-Gastroenterology, School of Medicine, Keio

• TADA Shinichiro

  Daiwa Shouken Clinic

• EBINUMA Hirotoshi

  Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Ke

• YAMAGISHI Yoshiyuki

  Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Ke

• OJIRO Keisuke

  Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Ke

• INOUE Mika

  Schering-Plough Center for the Study of Chronic Liver Diseases, School of Medicine, Keio University

• EINUMA Hirotoshi

  Department of Internal Medicine, School of Medicine, Keio University

• Saito Hidetsugu

  慶応義塾大学 医学部内科学

• Saito H

  Department Of Internal Medicine School Of Medicine Keio University

• Saito Hidetsugu

  Department Of Internal Medicine School Of Medicine Keio University

• Hibi T

  Keio Univ. Tokyo Jpn

• SUZUKI Hidekazu

  Department of Internal Medicine, School of Medicine, Keio University

• Inoue Mika

  Schering-plough Center For The Study Of Chronic Liver Diseases School Of Medicine Keio University

• Suzuki H

  Department Of Internal Medicine School Of Medicine Keio University

• Ojiro Keisuke

  Division Of Gastroenterology And Hepatology Department Of Internal Medicine School Of Medicine Keio

• Masuda Tetsuya

  Department Of Biological Science And Technology The University Of Tokushima Graduate School

• Shiozu Hidetoshi

  Division Of Gastroenterology And Hepatology Department Of Internal Medicine Keio University School O

• Suzuki H

  Kyoto Univ. Kyoto

• Masaoka T

  Department Of Emergency And Critical Care Medicine School Of Medicine Keio University

• Morishita Tetsuo

  Department Of Internal Medicine Tokyo Dental College

• Yamagishi Yoshiyuki

  Division Of Gastroenterology And Hepatology Department Of Internal Medicine School Of Medicine Keio

• Einuma Hirotoshi

  Division Of Gastroenterology And Hepatology Department Of Internal Medicine School Of Medicine Keio

• Ebinuma Hirotoshi

  Department Of Internal Medicine School Of Medicine Keio University

• Tsuchiya M

  Department Of Internal Medicine And Center For Integrated Medical Research School Of Medicine Keio U

• Masaoka Tatsuhiro

  Department Of Emergency And Critical Care Medicine School Of Medicine Keio University

• Ebinuma Hirotoshi

  Division Of Gastroenterology And Hepatology Department Of Internal Medicine School Of Medicine Keio

• Yamagishi Yoshiyuki

  Division Of Gastroenterology And Hepatology Department Of Internal Medicine Keio University School O

• Hibi Toshifumi

  Division Of Gastroenterology And Hepatology Department Of Internal Medicine Keio University School O

• Ebinuma Hirotoshi

  Division Of Gastroenterology And Hepatology Department Of Internal Medicine School Of Medicine Keio

• Hibi Toshifumi

  Division Of Gastroenterology And Hepatology Department Of Internal Medicine Keio University School O

• Masuda Tetsuya

  Department Of Animal Science And Resources College Of Bioresource Sciences Nihon University

• Tada Shinichiro

  Department Of Internal Medicine School Of Medicine Keio University

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