Theme |
Controversies Over Diagnosis and Treatment of Hepatocellular Carcinoma |
Title |
Efficacy of Percutaneous Tumor Ablation following Transcatheter Arterial Embolization for Multiple Hepatocellular Carcinomas |
Author |
Masahiko Katayama |
The 1st Department of Internal Medicine, Toho University School of Medicine |
Author |
Kazunari Iida |
The 1st Department of Internal Medicine, Toho University School of Medicine |
Author |
Noriko Goto |
The 1st Department of Internal Medicine, Toho University School of Medicine |
Author |
Yoshimi Hagisawa |
The 1st Department of Internal Medicine, Toho University School of Medicine |
Author |
Naoki Okano |
The 1st Department of Internal Medicine, Toho University School of Medicine |
Author |
Kazumasa Miki |
The 1st Department of Internal Medicine, Toho University School of Medicine |
[ Summary ] |
TAE is highly evaluated as an indispensable therapeutic method for the management of multiple HCCs. Most patients with advanced multiple HCCs are treated with repeated TAE after recurrence of HCCs. However, complete necrosis of all the HCC nodules is not easily attained through repeated TAE, because of the development of the collaterals, due to hepatic artery occlusion, following embolization or intimal injury from catheterization. Furthermore, the administration of Lipiodol to the non-tumorous hepatic parenchyma may worsen liver function, especially in cases of liver cirrhosis. In this paper, we discuss how additional percutaneous tumor ablation therapy (PEIT, PMCT, RFA) may be useful in cases with few viables or residual HCC nodules after TAE. |