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Korean J Hepatol > Volume 4(4); 1998 > Article
The Korean Journal of Hepatology 1998;4(4): 365-380.
소간세포암의 진단과 치료 및 예후 (A Clinical Study on Small Hepatocellular Carcinoma)
A Clinical Study on Small Hepatocellular Carcinoma
Kyoung Soo Kim, M.D., Soon Ho Um, M.D., Ho Sang Ryu, M.D., Mi Ra Park, PhD , Jae Won Lee, PhD , Dong Gyu Park, M.D., Sung Joon Lee, M.D., Goo Lee, M.D., Kwang Hee Kim, M.D., Yoon Tae Jin, M.D., Hoon Jai Chun, M.D., Chi Wook Song, M.D., Sang Woo Lee, M.D., Jai Hyun Choi, M.D., Chang Duck Kim, M.D., Hyun Jin Hai, M.D., Yoon Hwan Kim, M.D. and Sung Ok Seo, M.D.
Department of Internal Medicine, Radiology, Surgery, College of Medicine and Department of Statistics, Korea University, Seoul, Department of Statistics, Eulji Medical College, Daejun, Korea
Abstract
Background/ Aims : Cases of small hepatocellular carcinoma (HCC) have been increasing with the progress of diagnostic methods . In t his study the screening methods for early diagnos is of HCC were re-evaluated, and comparative ther apeutic analyses were perfomed.
Method
: A total of 110 pat ients with small HCC (< 5 cm and < 4 nodules ) were retrospectively analyzed. The patients were divided into four treatment groups ; unt reated group (No T x, n=12), transarterial-oily-chemoembolization group (TOCE, n=43), combined treatment group of percutaneous ethanol injection and TOCE (CEI, n=22), OP group ( OP, n=33). Results : Small HCC occupied 22.6% of t ot al HCC cases . Only one thir d of small HCC cases were detected during the regular screening. In this group, Alpha- fet oprotein as say pr ovided a diagnostic clue in 50% of cases, ultras onography in 71%, and the combination of both in 88%. Five year s ur vival rat e and 5- year non- recurrence rate in small HCC was 29% and 37% respectively. Comparative ther apeutic analys es showed t hat CEI and OP gave a bet t er s ur vival t han T OCE in Child gr ade A. CEI prolonged survival in Child grade B wher eas TOCE did not . Only TOCE was tried and did not improve the survival in Child grade C. Conclus i on : 1) A more strict screening is needed in high risk group of HCC. 2) As a first line of treatment in small HCC, OP or CEI can be selected in Child grade A, and CEI in Child grade B. In Child grade C, a less invasive treatment (PEIT , microwave coagulat ion therapy) should be investigated. (Korean J Hepatol 1998;4:365 380)
KeyWords: Small hepatocellular carcinoma, Diagnosis, Treatment, Prognosis
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