간세포암 치료에서 수술 전 간동맥 화학색전술의 효과
The effect of preoperative transcatheter hepatic arterial chemoembolization in the treatment of hepatocellular carcinoma
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목적 : 간동맥 화학색전술이 조직학적으로 어느 정도의 간세포암 괴사를 유발하는지에 대해 정확히 알려져 있지 않으며, 절제 가능한 간세포암에서 수술 전 간동맥 화학색전술을 시행하는 것이 효과가 있는지 아직 결론이 나지 않은 상태이다. 본 연구의 목적은 간동맥 화학색전술 시행 후 종양의 조직학적 괴사 정도를 측정하고, 절제 가능한 간세포암 환자에서 수술 전 간동맥 화학색전술의 효과를 알아보고자 하였다. 방법 : 1999년 1월부터 2004년 1월까지 한 차례의 간동맥 화학색전술 후 수술 받은 간세포암 환자 20명과 색전술 없이 간동맥 조영술만을 시행하고, 수술 받은 환자 36명을 대상으로 하였다. 결과 : 간동맥 화학색전술을 시행 받은 20명 중 12명에서 100%, 5명에서는 80∼99%, 나머지 3명에서는 50% 미만의 평균 종양 괴사율을 보였다. 5 cm 미만의 종양 크기를 가진 10명의 평균 괴사율은 84.7%이었고, 5 cm 이상의 종양 크기를 가진 10명의 평균 괴사율은 90.5%이었다(p>0.05). 간동맥 화학색전술 후 수술 받은 환자 중 재발한 4명과 색전술 없이 간동맥 조영술 후 수술 받은 환자 중 재발한 4명의 평균 괴사율은 각각 98.75%와 17.5%였으나(p<0.05), 무병 생존기간은 각각 16.8개월과 20.3개월이었다(p>0.05).
Abstract
Background : Transcatheter hepatic arterial chemoembolization (TACE) is used for curative or palliative treatment of hepatocellular carcinoma (HCC). However, it is neither well known how much TACE induces tumor necrosis histologically, nor whether preoperative TACE has benefit for resectable HCC. The purpose of this study is to measure the degree of tumor necrosis induced by one session of TACE and to evaluate the effect of preoperative TACE for resectable HCC. Methods : Between January 1999 and January 2004, 20 HCC patients with one session of preoperative TACE (TACE group) and 36 HCC patients with only preoperative hepatic angiography, without TACE (angiography group) were enrolled. Results : In TACE group, 12 patients had tumor necrosis of 100%, 5 patients having between 80% and 99%, and 3 patients less than 50%. The mean tumor necrosis rate of HCC less than 5 cm in diameter were 84.7%, while 90.5% in larger size (>5 cm in diameter) of HCC (p>0.05). The mean tumor necrosis rate of the recurred patients in TACE group and in angiography group was 98.75 and 17.5% (p=0.02), respectively. Disease free survival time of the recurred patients in TACE and in angiography group was 16.75 and 20.25 months, respectively (p=0.77). Conclusions : The tumor size was not related with the degree of tumor necrosis and no relevant factors could be found. Although the mean tumor necrosis was greater in TACE group than in angiography group, the disease free survival time was not different between the two groups.(Korean J Med 70:17-25, 2006)
참고문헌 (23)
- "Treatment outcome of transcatheter arterial chemoinfusion according to anticancer agents and prognostic factors in patients with advanced hepatocellular carcinoma (TNM stage IVa).", 45, pp.847~858 (2004)
- "Hepatic artery embolization in 120 patients with unresectable hepatoma", 148, pp.397~401 (1983)
- "Resection of hepatocellular carcinoma after transcatheter arterial embolization:reevaluation of the advantages and disadvantages of preoperative embolization", 122, pp.756~759 (1987)
- "Combined peripheral and central chemoembolization of liver tumors", 61, pp.238~242 (1988)
- "Liver resection after transcatheter hepatic arterial chemoembolization for hepatocellular carcinoma and curative effect analysis", 35, pp.710~712 (1997)
- "Improved survival for hepatocellular cancer with combination surgery and multimodality treatment", 217, pp.149~154 (1993)
- "Influence of preoperative transarterial lipiodol chemoembolization on resection and transplantation for hepatocellular carcinoma in patients with cirrhosis", 226, pp.688~701 (1997)
- "Role of preoperative transcatheter arterial oily chemoembolization for resectable hepatocellular carcinoma", 20, pp.326~331 (1996)
- "Effects of preoperative transcatheter hepatic arterial chemoembolization for hepatocellular carcinoma:the relationship between postoperative course and tumor necrosis", 72, pp.3593~3598 (1993)
- "Preoperative chemoembolization of hepatocellular carcinoma:a comparative study", 133, pp.767~772 (1998)
- "Preoperative transcatheter arterial chemoembolization for resectable large hepatocellular carcinoma:a reappraisal", 82, pp.122~126 (1995)
- "Preoperative transcatheter arterial chemoembolization and prognosis of patients with hepatocellular carcinoma:retrospective analysis of 120 cases", 23, pp.293~300 (1999)
- "Total necrosis of hepatocellular carcinoma due to spontaneous occlusion of feeding artery", 43, pp.123~127 (2002)
- "Spontaneous regression of hepatocellular carcinoma:a case report and literature review", 51, pp.579~582 (2004)
- "Influence of preoperative transcatheter arterial chemoembolization on liver resection in patients with resectable hepatocellular carcinoma", 1, pp.523~526 (2002)
- "Role of preoperative transcatheter arterial chemoembolization for resectable hepatocellular carcinoma:relation between postoperative course and the pattern of tumor recurrence", 27, pp.1295~1299 (2003)
- "Necrosis of hepatocellular carcinoma caused by spontaneously arising arterial thrombus", 41, pp.359~362 (1994)
- "Risk factors, prevention, and management of postoperative recurrence after resection of hepatocellular carcinoma.", 232, pp.10~24 (2000)
- "Survival and recurrence after hepatic resection of 386 consecutive patients with hepatocellular carcinoma", 191, pp.381~388 (2000)
- "A prospective randomized trial of the preventive effect of pre-operative trans catheter arterial embolization against recurrence of hepatocellular carcinoma", 87, pp.206~211 (1996)
- "Is preoperative hepatic arterial chemoembolization safe and effective for hepatocellular carcinoma?", 224, pp.4~9 (1996)
- "Hepatectomy with chemoembolization for treatment of hepatocellular carcinoma", 50, pp.750~755 (2003)
- "Experience with liver resection after hepatic arterial chemoembolization for hepatocellular carcinoma", 71, pp.62~65 (1993)