SIGNIFICANCE OF MULTIDISCIPLINARY THERAPY FOR HEPATOCELLULAR-CARCINOMA

被引:6
作者
KAWARADA, Y
IMAI, T
IWATA, M
YOKOI, H
NOGUCHI, T
MIZUMOTO, R
机构
[1] The First Department of Surgery, Mie University School of Medicine, Tsu City, Mie, 514
关键词
TAE; PSE; CONTINUOUS INTRAARTERIAL INFUSION THERAPY;
D O I
10.1007/BF00687098
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The effect of multidisciplinary therapy for hepatocellular carcinoma (HCC) was evaluated in 121 resected cases. The 5-year survival was 100% for absolute curative resection (12 cases), 59.1% for relative curative resection (n = 37) and 10.9% for relative non-curative resection (n = 59). However, none of the patients survived for more than 3 years after absolute non-curative resection (n = 13). The non-recurrence in the preoperative TAE groups was different from that in non-TAE groups undergoing absolute and relative curative resection. The 1- and 3-year non-recurrence rates for relative non-curative resection were 92.3% and 53.8%, respectively, for the preoperative TAE group and 56.1% and 28.1%, respectively for the non-TAE group. These data show that preoperative TAE is effective in relative non-curative resection. Functional disturbances of the coagulation-fibrinolysis system in cirrhotic patients were improved after PSE. All patients undergoing hepatectomy after PSE had an uneventful postoperative course, including well-maintained function of the coagulation-fibrinolysis system and a decrease in splenic volume. At 1 year after hepatectomy, cirrhotic patients with critical liver function and poor coagulation-fibrinolysis showed appreciable hepatic regeneration. One patient died of hepatic failure 1 year after the operation. In recurrent HCC, the 1-, 2- and 3-year survivial values after reresection were 100%, 75.0% and 25.0%, respectively. The respective values following TAE were 79.0%, 42.0% and 9.0%. Three cases of recurrent HCC were effectively treated, i.e., two patients achieved a partial response and one showed no change, by continuous intra-arterial infusion of 5-FU and lentinan with intermittent one-shot injections of epirubicin using a subcutaneous infusion pump. These three patients are alive at 1 year and 7 months, 1 year and 4 months and 6 months after the treatment, respectively.
引用
收藏
页码:S13 / S19
页数:7
相关论文
共 16 条
[1]  
[Anonymous], 1989, Jpn J Surg, V19, P98
[2]   PERCUTANEOUS ETHANOL INJECTION FOR THE TREATMENT OF SMALL HEPATOCELLULAR-CARCINOMA - STUDY OF 95 PATIENTS [J].
EBARA, M ;
OHTO, M ;
SUGIURA, N ;
KITA, K ;
YOSHIKAWA, M ;
OKUDA, K ;
KONDO, F ;
KONDO, Y .
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, 1990, 5 (06) :616-626
[3]  
FUJIWARA S, 1990, J JPN SURG SOC, V91, P1375
[4]   A PREOPERATIVE CHEMOEMBOLIZATION THERAPY USING LIPIODOL, CISPLATIN AND GELATIN SPONGE FOR HEPATOCELLULAR-CARCINOMA [J].
IMAOKA, S ;
SASAKI, Y ;
SHIBATA, T ;
FUJITA, M ;
KASUGAI, H ;
KOJIMA, J ;
ISHIGURO, S ;
OHIGASHI, H ;
ISHIKAWA, O ;
FUKUDA, I ;
FURUKAWA, H ;
KOYAMA, H ;
IWANAGA, T .
CANCER CHEMOTHERAPY AND PHARMACOLOGY, 1989, 23 :S126-S128
[5]   SELECTIVE EFFECTS OF LIPIODOLIZED ANTITUMOR AGENTS [J].
KANEMATSU, T ;
INOKUCHI, K ;
SUGIMACHI, K ;
FURUTA, T ;
SONODA, T ;
TAMURA, S ;
HASUO, K .
JOURNAL OF SURGICAL ONCOLOGY, 1984, 25 (03) :218-226
[7]  
Mizumoto R, 1979, Jpn J Surg, V9, P343, DOI 10.1007/BF02468635
[8]   2ND HEPATIC RESECTION FOR RECURRENT HEPATOCELLULAR-CARCINOMA [J].
NAGASUE, N ;
YUKAYA, H ;
OGAWA, Y ;
SASAKI, Y ;
CHANG, YC ;
NIIMI, K .
BRITISH JOURNAL OF SURGERY, 1986, 73 (06) :434-438
[9]  
OKUNO K, 1986, CANCER, V58, P1001, DOI 10.1002/1097-0142(19860901)58:5<1001::AID-CNCR2820580502>3.0.CO
[10]  
2-K