The strategy for the treatment of hepatocellular carcinoma

Between July 1994 and December 2005, 1,324 patients underwent hepatic surgery in our institute. Of these patients, 508 patients who received their initial therapy for HCC were analyzed this time. MCN (microwave coagulo-necrotic therapy) was performed in 369 patients, hepatic resection (Hr) was in 98, and Hr + MCN was in 38. The remaining 3 patients were treated with laparotomic ethanol injection.The 1-, 3-, 5-, and 10-year cumulative survival rates for patients treated with MCN (mean tumor size, 28.8mm ; mean number of lesion, 2.63 ; Liver Damage, A in 39.1%, B in 56.8%, and C in 4.1%) were 97.3%, 80.2%, 62.3%, and 35.1%, respectively. Five-year survival rate was 62.3% in MCN and 60.8% in Hr group (p = 0.6047). The 1-, 3-, and 5-year local recurrence rates with MCN were 1.8%, 4.3%, and 5.4%. and those with Hr were 1.1%, 4,1%, and 4.1% (p = 0.8990).The 1-, 3-, and 5-year cumulative survival rates for 109 patients, who had 4 or more tumors, were 95.0%, 69.0%, and 43.3%.The 3-, 5-, and 10-year cumulative survival rates for the liver damage-A-patients treated with MCN were 87.6%, 68.9%, and 31.6%. Those for the liver damage-B-patients with MCN were 77.2%, 59.5%, and 37.6%.Based on the above, it was suggested that MCN has the good ability of loco-regional control of HCC and it is less invasive to the patients, especially with multiple tumors and/or with severe liver function. Therefore, we recommend MCN as a first choice for the treatment of HCC.