Ikeda Kenji
Department of Hepatology, Toranomon Hospital.
Nihon Rinsho. 2010 Jun;68(6):1129-36.
Multimodality treatment is applied according to varied stages of hepatocellular carcinoma(HCC), and to varied status of liver function. Surgical resection is regarded as the most radical way of therapy for an early stage of HCC (single large tumor, or small tumor of 3cm or less with 3 nodules or less). Among percutaneous local ablation therapies, radiofrequency ablation is the most effective from the viewpoint of local recurrence and survival rate. Transcatheter arterial chemoembolization prolongs the survival period of those patients with an intermediate stage of HCC(tumors of more than 3cm and/or 4 nodules or more). Sufficient evidence of the efficacy of chemotherapy is still lacking for advanced stages of HCC with or without portal vein invasion. Although sorafenib is the first molecular targeted medicine approved for the advanced HCCs, its usefulness remains unknown in Japanese patients.
多模态治疗根据肝细胞癌(HCC)的不同阶段以及肝功能的不同状态来应用。手术切除被视为早期HCC(单个大肿瘤,或3cm及以下且结节数为3个及以下的小肿瘤)最彻底的治疗方式。在经皮局部消融治疗中,从局部复发和生存率的角度来看,射频消融是最有效的。经动脉化疗栓塞可延长中期HCC(肿瘤大于3cm和/或结节数4个及以上)患者的生存期。对于伴有或不伴有门静脉侵犯的晚期HCC,化疗疗效的充分证据仍然缺乏。尽管索拉非尼是首个被批准用于晚期HCC的分子靶向药物,但其在日本患者中的有效性仍不明确。