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KMID : 0882419930450020141
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Korean Journal of Medicine
1993 Volume.45 No. 2 p.141 ~ p.153
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Naural Hisory of Hepatocellular Carcinoma and Survival Rate in Relation to Various Treatment Modalities.
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김정룡
이준성/이한주/이효석/윤용법/송인성/박재형/김수태
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Abstract
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ackground : Hepatocellular carcinoma (HCC) is the most common form of primary hepatic carcinoma and is a pressing sociomedical problem in Korea. Of the various solid cancers. HCC is perhaps the most diffcult to treat brcause of the frequently
associated
cirrhosis and advsnced stage of tumor. In recent years, diagnostic procedures, surgical techniques and various therapeutic modalities other than surgery have been developed and improved. So the prognosis of these patients may have changed from
what
it
was in the past
and it is necessary to establish the criteria for selection of therapeutic modality in indivisual
patient with HCC. The purpose of this study was to elucidate the natural history of HCC and
the survival rate of patients with HCC in relation to various therapequtic modalities in
different stage of chronic liver disease.
Method : A total of 1149 patients with HCC seen during the last 20 years were analyzed
retropectively. The effects of treatment on survival were analyzed with regard to Child's
grading and UICC stage of HCC.
Results : In the 265 patients who received no specific treatment, the cumulative survival
rates of 6 month and 1 year were 37.5%, 16.6% and the median survival time was 4 months.
Survival rates of the surgically treated patients were better than that of other patients groups
in comparable Child's grade and UICC stage. Especially, among patients with Child's A or B
the actuarial survival rate for surgery was significantly better than that for transarterial
chemoembolization. Transarterial chemoembolization gave a significantly better survival rate
compared with systemic chemotherapy and no specific treatment in all child's grade and
UICC stage. Systemic chemotherapy improved survival as compared with no specific
treatment in Child's A or B patients and with UICC stage IVA and Child's C with stage
IVA patients. The major causes of death were hepatic failure and gastrointestinal bleeding
irrespective of treatment modality.
Conclusion : Adequate therapeutic modalities according to the severity of liver cirrhosis
and tumor stage could improve the prognosis of HCC patients.
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KEYWORD
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