Non-surgical Treatment of Hepatocellular Carcinoma

Abstract

Surgical treatment of hepatocellular carcinoma (HCC) is limited because of its association with liver cirrhosis in most cases. Our criteria for indication of surgical resection of nodular HCC, less than 3 cm in diameter, are the presence of a single nodule, located at the surface of the liver and liver cirrhosis classified as Child A. Patients for whom surgical resection was not indicated, were treated with US-guided percutaneous ethanol injection therapy (PEIT). We had 160 cases of nodular HCC, less than 3 cm in diameter, during the past last five years, 124 patients (single nodule: 40.3%) were treaed with PEIT and 36 patients (single nodule: 91.7%) by surgical resection. The 5-year survival of all patients was 48% and no difference was statistically noted in 5-year survival between surgical resection and PEIT. Analysis of PEIT revealed a 5 year-survival of 85% in patients with tumors 2 cm or less in diameter and Child A liver cirrhosis, and 95% in patients with very well differentiated (Edmondson's class I or I-II) tumors 1.5 cm or less in diameter. These findings indicate that the prognosis of such small HCC depends on the size of the tumor, histological atypism and severity of the associated liver cirrhosis. © 1990, The Japanese Society of Gastroenterological Surgery. All rights reserved.