Yokoi H, Kawarada Y
First Department of Surgery, Mie University School of Medicine, Japan.
Gan To Kagaku Ryoho. 1996 Jun;23(7):855-61.
In recent years ethanol injection therapy (PEI) and transcatheter hepatic arterial embolization (TAE) have come to be widely used in the treatment of small hepatocellular carcinoma, and the introduction of microwave coagulation therapy (MCT) more recently has made it possible to perform a variety of non-surgical treatments even in cases in which surgical resection has been indicated until now. There have also been reports based on survival rates that results comparable to those obtained by surgical resection can be achieved with non-surgical methods. The main issue is whether PEI or resection should be selected to treat small hepatocellular carcinomas. However, the recurrence rate after PEI is higher than after surgical resection, and according to our results, in patients with solitary lesions, especially when the tumor diameter is 2 cm or less, the level of malignancy in many cases is also low biologically, and postoperative survival rates (recurrence-free survival rates) are favorable [5 years : 85.0% (64.3%); 10 years: 67.9% (42.2%)]. After thoroughly evaluating liver function in these cases, while surgical resection should be considered first, it is also important to use a combination of various treatment methods rather than always resort to a single method.
近年来，乙醇注射疗法（PEI）和经导管肝动脉栓塞术（TAE）已广泛应用于小肝细胞癌的治疗，最近微波凝固疗法（MCT）的引入使得即使在迄今已表明需进行手术切除的病例中也能够开展多种非手术治疗。也有基于生存率的报道称，非手术方法可取得与手术切除相当的结果。主要问题在于治疗小肝细胞癌应选择PEI还是切除术。然而，PEI后的复发率高于手术切除，根据我们的结果，对于孤立性病变患者，尤其是肿瘤直径在2cm或以下时，很多情况下生物学恶性程度也较低，术后生存率（无复发生存率）良好[5年：85.0%（64.3%）；10年：67.9%（42.2%）]。在对这些病例的肝功能进行全面评估后，虽然应首先考虑手术切除，但采用多种治疗方法的联合而非总是采用单一方法也很重要。
