Multidisciplinary treatment of hepatocellular carcinoma

Tanikawa, Kyuichi

doi:10.1007/978-4-431-68177-9_32

Cited by 19 publications

(5 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[30][31][32] In particular, percutaneous ethanol injection (PEI) into small HCCs has resulted in longterm survival rates similar to those achieved with the best surgical series. 32 The 5-year recurrence rates are also similar, ie, 57% to 100% [33][34][35][36][37] for the surgical series and 64% to 100% 32,[38][39][40] with PEI. If we take into account the minimal discomfort to patients and the low cost of a procedure like PEI, which is performed on an outpatient basis, it seems reasonable to conclude that PEI is actually the most appropriate treatment for HCCs.…”

Section: Commentmentioning

confidence: 98%

No-Mortality Liver Resection for Hepatocellular Carcinoma in Cirrhotic and Noncirrhotic Patients

et al. 1999

View full text Add to dashboard Cite

Section: Commentmentioning

confidence: 98%

No-Mortality Liver Resection for Hepatocellular Carcinoma in Cirrhotic and Noncirrhotic Patients

et al. 1999

View full text Add to dashboard Cite

“…Complications that have been reported, in the mentioned series or in case reports include intraperitoneal hemorrhage, right pleural effusion, cholangitis or jaundice secondary to injury of bile ducts, liver abscess, hepatic infarction probably related to reflux of ethanol into portal vein branches, hemobilia, arterioportal shunt and instance of shock. Only two cases of neoplastic seeding along the needle track are reported, probably because the reflux of alcohol prevents this possibility [1][2][3][4][5][6][7][8][9][10][11][12][13]. Using larger volumes of ethanol per treatment session, as occurs with "single session" technique, the complication rate is higher, as reported in our series.…”

Section: Discussionmentioning

confidence: 56%

“…However, since a large number of these patients turned out to be inoperable (multifocal disease, high-risk, concomitance of other diseases, patient refusal, advanced age, etc., alternative therapies have been proposed. Among these, percutaneous ethanol injection (PEI) has been most widely tried in not advanced HCC [1][2][3][4][5][6][7][8][9][10][11][12][13]. Two features of HCC favor the toxic action of alcohol: hypervascularization and the difference in consistency between neoplastic and cirrhotic tissue.…”

mentioning

confidence: 99%

Intralesional ethanol in the treatment of unresectable liver cancer

et al. 1995

View full text Add to dashboard Cite

Percutaneous ethanol injection (PEI) under ultrasonography guidance has been widely tried in not advanced hepatocellular carcinoma (HCC). Ten years after the introduction of PEI, some conclusions of its indications can be drawn. In our series, 210 cirrhotic patients were treated; 141 with multisession PEI in an outpatient clinic, 57 with "single session" PEI under general anesthesia, and 12 with both. The 1-, 3-, and 5-year survival rates (by Kaplan-Meier method) were 953%, 65%, and 41% for Child class A patients with single HCC < or = 5 cm, and 88%, 47%, and 33% for patients with multiple HCC up to five lesions < or = 5 cm. In these patients the local recurrence rate was 15% and the new lesion rate at the 5-year follow-up was 74%. One death due to hemorrhage from esophageal varices in a Child class C patient treated by single session PEI occurred. The large number of cirrhotic patients demand for effective, safe, repeatable, low-cost treatment that can be offered at many centers. PEI meets all these requirements. PEI is proposed as the treatment of choice for the mentioned patients, excluding candidates for liver transplantation and surgical resection according to the predictive adverse factors currently in use. "Single session" technique widened the indications of traditional PEI to larger lesions.

show abstract

“…Multimodal approaches can increase not only the therapeutic effect, but also the risks and the costs involved. The advantages of a combined therapy should be proven to ensure that its associated risks have been properly considered 34,35 …”

Section: Other Treatments and New Insights For Advanced Hccmentioning

confidence: 99%

“…The advantages of a combined therapy should be proven to ensure that its associated risks have been properly considered. 34,35 Recently we tried concurrent chemoradiation therapy (CCRT) in patients with advanced HCC with portal vein thrombosis (PVT). A total of 54 patients were enrolled and randomized.…”

Section: Multimodality Therapymentioning

confidence: 99%