Surgical treatment for hepatocellular carcinoma

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  • KOJIMA KUNIAKI
    The 2nd Department of Surgery, Juntendo University School of Medicine
  • YOSHIMOTO JIROH
    The 2nd Department of Surgery, Juntendo University School of Medicine
  • OHTA HITOSHI
    The 2nd Department of Surgery, Juntendo University School of Medicine
  • SUGOU HIROYUKI
    The 2nd Department of Surgery, Juntendo University School of Medicine
  • FUJISAWA MINORU
    The 2nd Department of Surgery, Juntendo University School of Medicine
  • FUJIWARA NORIKO
    The 2nd Department of Surgery, Juntendo University School of Medicine
  • MIWA KEN
    The 2nd Department of Surgery, Juntendo University School of Medicine
  • NAKANO KAZUNAGA
    The 2nd Department of Surgery, Juntendo University School of Medicine
  • MATUMOTO RIKIO
    The 2nd Department of Surgery, Juntendo University School of Medicine
  • SUZUKI KUNIMI
    The 2nd Department of Surgery, Juntendo University School of Medicine
  • WATANABE SHIN
    The 2nd Department of Surgery, Juntendo University School of Medicine
  • OKUYAMA KOUICHI
    The 2nd Department of Surgery, Juntendo University School of Medicine
  • OHASHI KAORU
    The 2nd Department of Surgery, Juntendo University School of Medicine
  • OURA SHINSUKE
    The 2nd Department of Surgery, Juntendo University School of Medicine
  • FUKASAWA MASAKI
    The 2nd Department of Surgery, Juntendo University School of Medicine
  • BEPPU TOMOE
    The 2nd Department of Surgery, Juntendo University School of Medicine
  • FUTAGAWA SHUNJI
    The 2nd Department of Surgery, Juntendo University School of Medicine

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  • 肝細胞癌の外科治療

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1979年以来, 396例の原発性肝細胞癌入院症例を経験し, 切除例は153例39%である. 切除例の中, 肝硬変症例は82%を占める. 耐術例での5年累積生存率は49%であり, 5年累積無再発生存率は21%である. 肝癌切除後の残肝再発は, 肝硬変症例における多中心性発生例も含め高率であり, 長期生存を得るためには再発巣に対しても再切除をはじめとした積極的な治療が必要である. 再発に関与する因子としてもっとも重要なものは, 肝内転移の有無 (im因子) や治癒切除が行われたか否かである. また, 細胞核DNA PLOIDY PATTERNも予後に影響する重要な因子の一つである. 本論文では, 教室の肝細胞癌に対する治療方針とその適応・成績について自験例を中心に概説した.

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