小肝癌治療の展望 : 肝切除ならびにラジオ波焼灼療法の対比から

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  • Perspective of the Treatment for Small Hepatocellular Carcinoma : Hepatic Resection or Radiofrequency Ablation ?

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The long-term outcome of hepatocellular carcinoma (HCC) patients is influenced by parameters related to the tumor and the underlying chronic liver disease (CLD). Surgical treatment includes hepatic resection (HR) and liver transplantation (LT). In HCC with mild or without CLD, resection is the treatment of choice; however, resection of the cirrhotic liver and/ or steatotic liver always carries a high risk of intraoperative hemorrhage and postoperative hepatic failure. Thus, in the presence of cirrhosis, LT is considered to be the gold-standard in patients within Milan or UCSF criteria. Unfortunately, the shortage of liver donors restricts the availability of transplantation in a timely manner. Recently, short and long term results after HR for HCC patients with CLD have been improved due to both early detection and low morbidity. This improvement has led to a renewed interest in HR for HCC in the presence of CLD. Ablation techniques such as radiofrequency ablation therapy (RFA) have also been developed as a therapy for small HCC. The following article focuses on the current role of HR and RFA in the treatment of small HCC.

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