Non-invasive loco-regional therapy for hepatocellular carcinoma

It is important to understand characteristic features of hepatocellular carcinoma (HCC) for its treatment, namely most HCC is associated with liver cirrhosis and is characterized by multicentric development. Percutaneous ethanol injection therapy (PEIT) has preferably been performed in Japan for small HCC, less than 30 mm in diameter, because no difference was found in the survival rate between patients treated by PEIT and surgical resection. One of the most important factors affecting the prognosis of PEIT was regular follow-up after treatment. For advanced nodular HCC, larger than 30 mm in diameter, transcatheter arterial chemo-embolization has usually been carried out. The prognosis of arterial chemotherapy for highly advanced HCC has been improved remarkably by using an implantable injection port. Additionally, the prevention of HCC recurrence after initial successful treatment has become an urgent problem.