The present status of treatments for hepatocellular carcinoma

In Japan, hepatocellular carcinoma (HCC) has developed almost exclusively in patients with chronic liver diseases associated with hepatitis B virus (HBV) or hepatitis C virus (HCV). Small HCCs have been found in considerable numbers when following up such patients. Percutaneous ethanol injection therapy (PEIT) has become an important therapy for small HCCs, with a 5-year survival rate of > 50%, similar to that of surgical resection. Such patients must be followed every 3 months even after the initial successful treatment in order to detect newly developed lesions. For nodular HCCs, transcatheter chemoembolization (TAE) is the treatment of choice for advanced disease, but it is not a curative treatment; it can be given with PEIT with better results. Very advanced HCCs are usually treated with intra-arterial chemotherapy and the prognosis has been improved by using an implantable injection port system. The search continues for a means to prevent the recurrence of HCC after successful treatment.