臨牀消化器内科 Vol.12 No.11(9-3)

特集名	肝疾患の予後
題名	肝細胞癌の予後 (3) 選択的肝動脈塞栓術
発刊年月	1997年 10月
著者	代田幸博	金沢大学医学部第一内科
著者	小林健一	金沢大学医学部第一内科
【要旨】	肝細胞癌に対する治療法の一つである肝動脈塞栓術，とくに選択的肝動脈塞栓術の予後を当科における成績に基づいて概説する．選択的肝動脈塞栓術の局所再発率は1年30.8%，2年47.8%に認められ高率であった．しかし3年以降の局所再発の増加は認められず，再治療にて十分な抗腫瘍効果と，良好な生命予後(3年70.9%，5年48.5%)が得られた．一方他部位再発は1年37.5%，2年67.7%と局所再発よりも高率であり，その多くが多中心性発生であった．患者の生命予後を考えるうえで，多中心性発生を特徴とする肝細胞癌の治療法として肝予備能を温存し頻回に行える選択的肝動脈塞栓術は有効な治療法の一つである．

Theme	Prognosis of Liver Diseases
Title	Prognosis of Hepatocellular Carcinoma : Treatment with Selective Transcatheter Arterial Embolization
Author	Yukihiro Shirota	First Department of Internal Medicine, School of Medicine, Kanazawa University
Author	Kenichi Kobayashi	First Department of Internal Medicine, School of Medicine, Kanazawa University
[ Summary ]	The prognosis of hepatocellular carcinoma (HCC) patients treated with selective transcatheter embolization (sTAE) in our institute is reviewed herein. The local recurrence rates of HCC after sTAE treatment were relatively lower than those after conventional TAE. The local recurrence rates 1 and 3 years after treatments amounted to 30.8% and 47.8%, respectively. However, 3 years after the treatments, the number of local recurrences reached a plateau, indicating that the treatments for local recurrence were sufficiently effective to inhibit recurrence and thereby contributed to good survival rates : survival rates 3 and 5 years after treatments were 70.9% and 48.5%, respectively. On the other hand, the 1- and 3-year rates of distant recurrences were 37.5 % and 67.7%, respectively, higher than those of local recurrences. Furthermore, most of the distant recurrences occurred in a multicentric pattern. In addition, sTAE could be performed repetitively. It is concluded that sTAE may be a useful anti-tumor treatment for local recurrences of HCC, contributing to better survival of patients. In conclusion, sTAE may be a useful anti-tumor treatment for local recurrence of HCC.

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