Segawa T, Izawa K, Tsunoda T, Kanematsu T, Shima M, Matsunaga N, Hayashi K
Second Department of Surgery, Nagasaki University School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1992 Sep;93(9):1095-9.
Therapeutic effect on 81 hepatectomized patients with hepatocellular carcinoma (HCC) less than 5cm in diameter was compared to that achieved by transcatheter arterial embolization therapy (TAE) in 61. The 5-year cumulative survival rate after hepatectomy was 38%, which was better than that of TAE (8%). Outcome after hepatectomy was better than that after TAE, according to tumor size in less than 2cm in diameter and single nodule. The 3-, and 5-year survival rates for curative hepatectomy were significantly better than those for TAE. But there was no significant difference in survival curves between relative noncurative hepatectomy and TAE. In terms of hepatic reserve with reference to Child's classification, the survival curve for TAE was better than that for relative noncurative hepatectomy in patients with Child-A, but there was no significantly difference between these two methods. Survivors more than 3 years after hepatectomy and TAE were 24 (48.0%) and 11 (23.4%) patients, respectively. Nineteen of 24 patients with hepatectomy had recurrent HCCs, of which reresection was done in 6, TAE in 11 and other treatments in 2. The advantage of hepatectomy in comparison with TAE is a possibility of long-term survival, if curative hepatectomy is performed.
将81例直径小于5cm的肝细胞癌（HCC）肝切除患者的治疗效果与61例经导管动脉栓塞治疗（TAE）患者的治疗效果进行了比较。肝切除术后的5年累积生存率为38%，优于TAE组（8%）。根据肿瘤直径小于2cm且为单个结节的情况，肝切除术后的结果优于TAE术后。根治性肝切除的3年和5年生存率明显优于TAE。但相对非根治性肝切除与TAE的生存曲线无显著差异。就参照Child分级的肝储备而言，Child-A级患者中TAE的生存曲线优于相对非根治性肝切除，但这两种方法之间无显著差异。肝切除和TAE术后存活超过3年的患者分别为24例（48.0%）和11例（23.4%）。24例肝切除患者中有19例出现复发性肝癌（HCC），其中6例行再次切除，11例行TAE，2例行其他治疗。与TAE相比，肝切除的优势在于，如果进行根治性肝切除，有可能实现长期生存。
