演題抄録

International Symposium

開催概要
開催回
第51回・2013年・京都
 

HBV, HCV-related Hepatocellular Carcinoma

演題番号 : IS1-4

[筆頭演者]
Masatoshi Kudo:1 

1:Department of Gastroenterology and Hepatology, Kinki University School of Medicine, Japan

 


In Japan hepatocellular carcinoma (HCC) is treated based on the evidence-based and consensus-based treatment guidelines established by Japan Society of Hepatology. For early stage HCC, i. e., HCCs < 3cm and < 3nodules are treated by curative treatment modality such as surgical resection or radiofrequency ablation (RFA).
However, HCCs recurs even after curative treatment. Annual recurrence rate of HCCs after resection or ablation is 15-20%, results in 80% recurrence after treatment. Therefore, repeated treatment is definitely necessary. For intermediate HCCs, i.e. , HCCs larger than 3cm in diameter or HCCs more than 4 nodules are treated by transarterial chemoembolization (TACE) or hepatic arterial infusion chemotherapy (HAIC). TACE is a very effective treatment, however, at the certain point HCCs become no response to TACE, which is called TACE failure or refractoriness. For HCCs of TACE failure, HAIC or molecular targeted therapy is recommended according to the guidelines. For advanced HCCs, i.e. , HCCs with vascular invasion or extrahepatic spread systemic therapy using molecular targeted agent, sorafenib, is recommended. For patients with impared liver function (Child-Pugh C grade) and tumors within Milan criteria, liver transplantation is performed.
As mentioned above, HCCs are treated by multimodal approach in Japan, resulting in the prognosis of Japanese patients with HCCs being the best in the world. Nationwide survey data by Liver Cancer Study Group of Japan clearly show 5 year survival rate of 43% and median survival time (MST) of 50 months, as compared with 5 year survival rate of 5% and MST of 4 months 28 years ago in Japan.
It is expected that development of new first line and second line molecular targeted agents and combination therapy with conventional treatment modality such as TACE, HAIC, resection and ablation will further improve the survival in patients with HCCs.

前へ戻る