Transcatheter arterial embolization for hepatocellular carcinoma. Comparison with operation, intra-arterial chemotherapy, and no treatment.

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594 patients with hepatocellular carcinoma (HCC) were divided into subgroups based on tumor size, Child's Stages, and presence or abscence of portal vein tumor thrombus, in order to evaluate the therapeutic effect on survival of transcatheter arterial embolization (TAE) in comparison with that of operation, intra-arterial chemotherapy, and no treatment.<BR>Among Child's B patients with HCC less than 5cm in diameter and also patients with HCC more than 5cm in diameter and smaller than 50% of liver area regardless of Child's stages, which did not invade in portal vein trunk, the survival rate for TAE was better than that for intra-arterial chemotherapy and no treatment. These results suggest that TAE is the excellent non-surgical treatment in these groups. But tumor-related death (cancer death and tumor rupture) was the leading cause of death in cases treated by TAE, even though the size of tumor was less than 5cm in diameter.<BR>In comparison with operation, the survival rate for TAE was worse than that for operation in Child's A patients, but comparable to operation in Child's B patients with HCC less than 5cm in diameter. The advantage of TAE in comparison with operation remains to be further investigated in Child's B patients with HCC less than 5cm in diameter and also in Child's A and Child's B patients with HCC more than 5cm in diameter and smaller than 50% of liver area.
社団法人日本肝臓学会の論文