title: Nonsurgical treatment of hepatocellular carcinoma: from percutaneous ethanol injection therapy and percutaneous microwave coagulation therapy to radiofrequency ablation.
abstract: Treatment of hepatocellular carcinoma (HCC) is different from that of other solid tumors, in that surgery plays a limited role while nonsurgical therapies are very instrumental. At our institute, 90% of previously untreated patients have received image-guided percutaneous tumor ablations, such as percutaneous ethanol injection therapy (PEIT), percutaneous microwave coagulation therapy (PMCT) and radiofrequency ablation (RFA). We performed PEIT in 756 patients with HCC. Their survival rates were 89% at 1 year, 64% at 3 years, 39% at 5 years, and 18% at 10 years. With PMCT, survival rates of 122 new patients with HCC were 90% at 1 year, 87% at 2 years, and 68% at 3 years. We performed RFA in 324 patients. RFA required fewer treatment sessions and a shorter hospital stay than PEIT or PMCT to achieve complete necrosis of the lesions. By virtue of their local curability, minimal effect on liver function, and easy repeatability for recurrence, image-guided percutaneous tumor ablations, especially RFA, will be increasingly important in the treatment of HCC.
authors.affiliation: Department of Gastroenterology, University of Tokyo, Japan. sshiina-tky@umin.ac.jp
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Shiina
authors.forename: Takuma
authors.initials: T
authors.lastname: Teratani
authors.forename: Shuntaro
authors.initials: S
authors.lastname: Obi
authors.forename: Keisuke
authors.initials: K
authors.lastname: Hamamura
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Koike
authors.forename: Masao
authors.initials: M
authors.lastname: Omata
mesh_terms: D000279:Administration, Cutaneous; D001777:Blood Coagulation; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D017115:Catheter Ablation; D000431:Ethanol / Q000627:therapeutic use*; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy*; D008872:Microwaves / Q000627:therapeutic use*
chemical_list: D000431:Ethanol