Nakaji So, Hirata Nobuto, Mikata Rintaro, Kobayashi Masayoshi, Shiratori Toshiyasu, Ogasawara Sadahisa, Ooka Yoshihiko, Tsuyuguchi Toshio, Yamaguchi Taketo, Yokosuka Osamu
Department of Gastroenterology, Kameda Medical Center.
Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University.
Endosc Int Open. 2016 Oct;4(10):E1111-E1115. doi: 10.1055/s-0042-116146. Epub 2016 Sep 30.
Accurately puncturing hepatocellular carcinomas (HCC) that arise from the caudate lobe is generally considered to be technically difficult. We conducted a retrospective study to evaluate the feasibility and safety (the therapeutic outcomes and adverse events) of endoscopic ultrasound (EUS)-guided ethanol injection as a novel treatment for HCC in the caudate lobe. Twelve patients with early-stage HCC of the caudate lobe that were treated with EUS-guided ethanol injection at two tertiary referral centers were reviewed retrospectively. To evaluate the therapeutic effect of the treatment, a local control curve and an overall survival curve were constructed using the Kaplan-Meier method. The mean follow-up duration was 31.0 months. The 1-year local control rate was 80.2 %, and recurrent lesions developed in 2 cases (after 3 and 9 months, respectively). The overall survival rate was 91.7 %, 75.0 %, and 53.3 % at 1, 2, and 3 years, respectively. Concerning procedure-related adverse events (AEs), 2 patients suffered episodes of fever lasting a few days; however, no serious AEs occurred. EUS-guided ethanol injection could be a useful treatment for early-stage HCC in the caudate lobe because of its simplicity and reduced invasiveness.
准确穿刺源自尾状叶的肝细胞癌（HCC）通常被认为在技术上具有挑战性。我们进行了一项回顾性研究，以评估内镜超声（EUS）引导下乙醇注射作为尾状叶HCC新治疗方法的可行性和安全性（治疗效果和不良事件）。回顾性分析了在两个三级转诊中心接受EUS引导下乙醇注射治疗的12例尾状叶早期HCC患者。为评估治疗效果，采用Kaplan-Meier法构建局部控制曲线和总生存曲线。平均随访时间为31.0个月。1年局部控制率为80.2%，2例出现复发病变（分别在3个月和9个月后）。1年、2年和3年的总生存率分别为91.7%、75.0%和53.3%。关于与操作相关的不良事件（AE），2例患者出现持续数天的发热；然而，未发生严重AE。由于其操作简单且侵袭性降低，EUS引导下乙醇注射可能是尾状叶早期HCC的一种有效治疗方法。
