肝細胞癌の治療戦略―肝切除and/orマイクロ波凝固壊死療法？―

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Between July 1994 and December 2006, 1,567 patients underwent hepatic surgery in our institute. Of these patients, 613 patients who received their initial therapy for HCC were analyzed this time. MCN (Microwave Coagulo-Necrotic Therapy) was performed in 456 patients, hepatic resection (Hr) was in 111, and Hr + MCN was in 42. The remaining 4 patients were treated with laparotomic ethanol injection.The 1-, 3-, 5-, and 10-year cumulative survival rates for all patients treated with MCN (mean tumor size, 28.2 mm; mean number of lesion, 2.62) were 97.5%, 77.6%, 58.7%, and 37.3%, respectively. Five-year survival rate was 58.7% in MCN and 56.4% in Hr group (p = 0.9480).The 1-, 3-, 5-, and 10-year cumulative survival rates for 238 patients treated with MCN who had 3 or fewer lesions and 3 cm or less in diameter were 98.1%, 85.2%, 70.3% and 43.5%. No significant differences were found in cumulative survival rates after MCN or Hr (p = 0.7358), nor were there any differences in disease free survival rates and local recurrence rates between MCN and Hr groups.Of 613 patients, 319 patients had recurrences after on average 639.6 post operative days. Including 61 patients who had four or more recurrent lesions, 204 patients could be treated with MCN (mean tumor size, 3.7 mm; mean number of lesion, 3.08).Based on the above, it was suggested that MCN has the good ability of loco-regional control of HCC and it is especially suitable for the treatment with multiple tumors in initial or recurrent states. Therefore, we recommend that not only Hr but also MCN should be used as a first choice for the treatment of HCC.
特定非営利活動法人 Microwave Surgery研究会の論文

肝細胞癌の治療戦略―肝切除and/orマイクロ波凝固壊死療法？―

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