Kanematsu T, Matsumata T, Shirabe K, Sugimachi K, Sakamoto S, Nawata H, Hasuo K, Honda H, Masuda K
Second Department of Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Cancer. 1993 Apr 1;71(7):2181-6. doi: 10.1002/1097-0142(19930401)71:7<2181::aid-cncr2820710703>3.0.co;2-3.
Because transcatheter arterial embolization (TAE) has been shown to be effective in patients with unresectable hepatocellular carcinoma (HCC), the question arises whether TAE has an equivalent or superior effect on resectable HCC compared with surgery. To clarify this point, the authors compared the therapeutic results achieved by surgery and TAE in patients with early-stage HCC and well-preserved liver function, who were independently treated by two different policies in two separate departments of the same university hospital during the same period.
From 1983 to 1987, 67 patients with HCC underwent hepatic resection at the Department of Surgery of Kyushu University Hospital. During the same period, TAE was the treatment of first choice for HCC, and surgical resection was not chosen in the Department of Internal Medicine of the hospital. TAE was done in 68 patients, who were evaluated blindly in terms of liver function reserve and roentgenographic resectability of the tumor. Among the 68 patients, 20 were thought to have anatomically and functionally resectable disease. The therapeutic results obtained in the two groups were compared.
The 1-year, 3-year, and 5-year cumulative survival rates for 67 patients undergoing surgery, including one operative death and four hospital deaths, were 89.1%, 74.6%, and 54.6%, respectively. However, the rates were 90.0%, 50.0%, and 17.5%, respectively, for the 20 patients treated with TAE; these differences were statistically significant (P < 0.05).
Surgery can offer more favorable results in patients with early-stage HCC compared with TAE.
由于经导管动脉栓塞术（TAE）已被证明对无法切除的肝细胞癌（HCC）患者有效，因此出现了一个问题，即与手术相比，TAE对可切除的HCC是否具有同等或更好的效果。为了阐明这一点，作者比较了同一大学医院两个不同科室在同一时期分别采用两种不同策略独立治疗的早期HCC且肝功能良好的患者，手术和TAE所取得的治疗效果。
1983年至1987年，67例HCC患者在九州大学医院外科接受了肝切除术。同一时期，TAE是该医院内科治疗HCC的首选方法，未选择手术切除。68例患者接受了TAE治疗，并对其肝功能储备和肿瘤的影像学可切除性进行了盲法评估。在这68例患者中，20例被认为在解剖学和功能上可切除。比较了两组的治疗效果。
67例接受手术的患者，包括1例手术死亡和4例医院死亡，其1年、3年和5年累积生存率分别为89.1%、74.6%和54.6%。然而，20例接受TAE治疗的患者的生存率分别为90.0%、50.0%和17.5%；这些差异具有统计学意义（P<0.05）。
与TAE相比，手术对早期HCC患者可提供更有利的治疗结果。
