https://scholars.lib.ntu.edu.tw/handle/123456789/548933
標題: | Current role of local ablative treatments for hepatocellular carcinoma | 作者: | GUAN-TARN HUANG JA-DER LIANG JIN-CHUAN SHEU |
關鍵字: | Catheter ablation; Diathermy; Ethanol; Hepatocellular carcinoma; Injection; Microwaves | 公開日期: | 2004 | 卷: | 103 | 期: | 6 | 起(迄)頁: | 403-410 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Due to modern diagnostic imaging and the sensitive alpha-fetoprotein test, small hepatocellular carcinoma can now be detected at an early stage. Studies have shown that surgical resection of the tumors is a valuable treatment. Local treatment under ultrasound guidance was initially considered as an alternative when patients' liver reserves were not good enough for surgical resection; however, this technique has been improved and the results indicate that its survival rate can compete with that of surgical resection. In follow-up studies of patients with small hepatocellular carcinoma, a 5-year survival of 60% has been achieved after percutaneous ethanol injection therapy. Percutaneous microwave coagulation therapy and percutaneous radiofrequency ablation therapy have been shown to have some advantages over percutaneous ethanol injection therapy, although the follow-up durations of these studies were not long enough. Percutaneous ethanol injection therapy, percutaneous microwave coagulation therapy and percutaneous radiofrequency ablation therapy have become the 3 most widely used techniques for the treatment of hepatocellular carcinomas that are less than 5 cm in diameter and have a tumor number less than 3. In general, a tumor size of 3 to 5 cm is a good candidate for radiofrequency ablation and a tumor size of 2 to 3 cm is suitable for radiofrequency ablation or microwave coagulation. If the tumor size is around 2 cm or less, microwave coagulation or ethanol injection is often chosen due to the relatively low cost and similar efficacy. Ethanol injection also has the advantage of needing only a fine needle for injection. Informed selection of the appropriate technique, or combining a technique with transcatheter hepatic arterial embolization according to the tumor size and number, might provide the most effective treatment and achieve better results for hepatocellular carcinoma, even if the liver reserve is not good. However, large-scale, randomized, controlled trials are required before a definitive conclusion can be reached. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-4444239190&partnerID=40&md5=847b08d9960323c1d34864d01489679b https://scholars.lib.ntu.edu.tw/handle/123456789/548933 |
ISSN: | 0929-6646 | SDG/關鍵字: | acetic acid; alcohol; alpha fetoprotein; analgesic agent; picibanil; sodium chloride; alcohol; abdominal bleeding; abdominal discomfort; abdominal infection; abscess; artificial embolism; ascites; bile duct fistula; bile duct injury; biloma; bleeding; blood clotting disorder; burn; cancer pain; cancer survival; cancer transplantation; catheter ablation; clinical trial; cost effectiveness analysis; cryosurgery; diathermy; drug megadose; echography; fever; gastrointestinal disease; heart injury; human; hyperthermic therapy; liver abscess; liver cell carcinoma; liver disease; liver failure; liver injury; liver resection; low level laser therapy; microwave therapy; myoglobinuria; nonsurgical invasive therapy; pleura effusion; pneumothorax; review; treatment contraindication; tumor volume; vein thrombosis; catheter ablation; endoscopic echography; liver cell carcinoma; liver tumor; methodology; microwave radiation; Carcinoma, Hepatocellular; Catheter Ablation; Ethanol; Humans; Liver Neoplasms; Microwaves; Ultrasonography, Interventional |
顯示於: | 醫學系 |
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