Therapeutic value of hepatectomy and transcatheter arterial embolization (TAE) for hepatocellular carcinoma]

Therapeutic value of hepatectomy and TAE was evaluated retrospectively in 150 hepatectomized and 117 non-hepatectomized patients of hepatocellular carcinoma (HCC). Operative death was seen in 5 patients. Cumulative 5 years survival rate and disease free cumulative 5 years survival rate of the 145 hepatectomized patients were 35.4 per cent and 23.6 per cent respectively. These survival rates were significantly affected by tumor size, intrahepatic metastasis (IM) and vascular invasion (Vp). But the influences of tumor margin (TW) and curative resection (relative curative or relative non-curative) were slight. Ninety-two patients (69:dead, 23:alive) had tumor recurrences. TAE was performed in 56 out of 92 patients effectively and 2 years survival rate was 31.5 per cent. Overall cumulative 5 years survival rate of non-hepatectomized patients was 6.6 per cent, but this group showed a more reduced hepatic reserve and more advanced tumor stage. Six patients treated by TAE survived more than 4 years. Hepatectomy is a first option for the treatment of HCC since complete cure may be estimated. However, because of operative risk and higher recurrence rate, use of current multidisciplinary treatment including TAE is necessary for the prognostic improvement of HCC with or without hepatectomy.