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괴상형 간세포암(Massive Hepatocellular Carcinoma)을 치료할 것인가? Pros
배시현 ( Si Hyun Bae ) 대한간암학회 2009 대한간암학회지 Vol.9 No.-
Although advanced HCCs larger than 10 cm in diameter are still often seen, the survival benefit and safety of the treatments for patients with huge hepatocellular carcinoma is uncertain. With conservative management, median survival in patients whose huge tumor invades the main portal vein is approximately 3 months. Surgical resection is the only way to cure the disease for patients with big tumours. However, huge tumors frequently present with poor liver reserve, vascular invasion and intrahepatic dissemination, all the factors limit the resectability of huge HCC. Transcatheter arterial chemoembolization (TACE) is a main palliative treatment for unresectable HCC. For unresectable HCC larger than 10 cm in diameter, TACE is the only treatment option. Responses to transarterial chemotherapy are infrequent and there exists considerable skepticism as to the value of the therapy because it could give rise to excessive liver damage for huge HCCs. The recent study suggests that patients with HCC larger than 10 cm in diameter are not suitable candidates for TACE treatment because of a high mortality rate due to serious side effects. Whether TACE is beneficial or not for this type of patient deserves further study. Several investigators have sought to delineate potential benefits of various therapies, although the lack of consensus regarding standards of care in advanced HCC. There are only a limited number of reports to date focusing on TACE for patients with HCC larger than 10 cm in diameter. Herein, we conducted this retrospective, case-control study to elucidate the outcome of multimodal therapies based on TACE for patients with huge unresectable HCC and determine the factors that are independently associated with the survival.
배시현 ( Si Hyun Bae ),장정원 ( Jeong Won Jang ),김민수 ( Min Soo Kim ),오현종 ( Hyun Jong Oh ),최종영 ( Jong Young Choi ),한남익 ( Nam Ik Han ),윤승규 ( Seung Kew Yoon ),한준열 ( Joon Yeol Han ),오은지 ( Eun Jee Oh ),김동구 ( Don 대한소화기학회 2005 대한소화기학회지 Vol.45 No.5
Liver transplantation is the only curative therapy for patients with end-stage liver disease. The high success rate and the increasing demand for the transplantation sometimes calls for ABO-compatible but nonidentical blood group orthotopic liver transpla