Multidisciplinary treatment of hepatocellular carcinoma

  • Kyuichi Tanikawa


Approximately 90% of hepatocellular carcinoma (HCC) in Japan is associated with chronic liver diseases (mostly liver cirrhosis) and development in the liver is considered to be multicentric. In addition, vascular invasion occurs in the early stages. For these reasons, even small HCC occasionally cannot be removed surgically, and thus, the treatment of HCC is remarkably different from other malignancies. Our studies have indicated that 33.5% of 200 cases of small HCC less than 2 cm in diameter are multinodular [1], and there were recurrent tumors in most cases 5 years after initial successful treatment with surgical resection or percutaneous ethanol injection therapy (PEIT). Autopsy studies have also shown that a high frequency of extrahepatic metastasis is observed in cases with tumors more than 5 cm in diameter. Thus, surgical resection, the preferred treatment of malignancies, is limited.


Multidisciplinary Treatment Extrahepatic Metastasis Lymphokine Activate Killer Small Hepatocellular Carcinoma Partial Splenic Embolization 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Tanikawa K (1991) Recent advance in treatment of hepatocellular carcinoma with reference to the indication. Surg Ther (Geka-Chiryo) 64: 172–176Google Scholar
  2. 2.
    The Liver Cancer Study Group of Japan (1990) Primary liver cancer in Japan. Ann of Surg 211: 277–287Google Scholar
  3. 3.
    Fujimoto T, Majima Y, Tanaka M, Iwai I, Sakai T, Hirai K, Abe M, Tanikawa K, Kenmochi K (1986) Investigation of percutaneous ultrasonographycally-guided ethanol injection therapy ( PEIT) for treatment of small hepatocellular carcinoma. Acta Hepatologica Japonica 27: 1559–1567CrossRefGoogle Scholar
  4. 4.
    Ebara M, Kita K, Ohoto M (1990) Therapeutic result of percutaneous ethanol injection ( PEI) therapyfor small hepatocellular carcinoma—Long-term prognosis and recurrence in nontreated area of the liver. Acta Hepatologica Japonica 31: 244–245Google Scholar
  5. 5.
    Tanikawa K (1990) Non-surgical treatment of hepatocellular carcinoma. Jpn J Gastroenterol Surg 23: 2492–2496CrossRefGoogle Scholar
  6. 6.
    Tanikawa K, Iwai I, Majima Y (1990) Tumor growth rate and cell differentiation in HCC. In: Sung JL,Chen DS (eds) Viral hepatitis and hepatocellular carcinoma. Excerpta Medica, Hong Kong, pp 646–650Google Scholar
  7. 7.
    Tanaka K, Okazaki H, Nakamura S, Hoshino M, Nagase H, Endoh O, Inoue S, Takamura Y (1990) Evaluation of combination therapy with transcatheter arterial embolization and percutaneous ultrasonographically-guided ethanol injection therapy in patients with advanced hepatocellular carcinoma. Acta Hepatologica Japonica 31: 944–951CrossRefGoogle Scholar
  8. 8.
    Gyves JW, Ensminger WD, Miederhuber JE, Dent T, Walker S, Gilbertson S, Cozzi E, Sarran P (1984) Atotally implanted injection port system for blood sampling and chemotherapy administration. JAMA 251: 2538–2541PubMedCrossRefGoogle Scholar
  9. 9.
    Fukushima H (to be published) (1991) Subrenal capsule assay using liver cancer specimens obtained by the fine needle biopsy. Kurume Med JGoogle Scholar
  10. 10.
    Nagashima T, Ryu M, Mukai M, Ariga T, Koh Z, Amano H, Furukawa T, Maruyama T, Yamamoto Y, Odaka M, Isono K, Arimizu N, Uematsu S, Ishikawa T (1987) Therapy of hepatocellular carcinoma complicated with intravascular tumor emboli-Effectiveness of radiotherapy for tumor emboli. Acta Hepatologica Japonica 28: 735–744CrossRefGoogle Scholar
  11. 11.
    Tsuzuki T, Iida S, Kasajima M, Ueda M, Ozawa I, Ogata Y, Kawada K (1988) Aggressive surgery for patients with hepatocellular carcinoma and hepatoblastoma with tumor thrombi in the portal trunk, hepatic vein, inferior vena cava and right atrium. Acta Hepatologica Japonica 29: 1222–1232CrossRefGoogle Scholar
  12. 12.
    Nagata Y, Hiraoka M, Akuta K, Abe M, Takahashi M, Jo S, Nishimura Y, Masunaga S, Fukuda M, Imura H (1990) Radiofrequency thermotherapy for malignant liver tumors. Cancer 65: 1730–1736PubMedCrossRefGoogle Scholar
  13. 13.
    Tanaka M, Ogata H, Yoshimoto K, Noguchi K, Sata M, Abe M, Tanikawa K (1989) Harvest of liversinusoidal large granular lymphocytes (Pit cells) and augmentation of natural killer activity by the administration of OK-432. In: Wisse E, Knook DL, Decker K (eds) Cells of the hepatic sinusoid, Vol 2. The Kupffer Cell Foundation, HV Rijiswijk, The Netherlands, pp 451–455Google Scholar
  14. 14.
    Murata T (1988) Studies on the effectiveness of hyperthermia combined with arterial therapeutic blockage in the treatment of tumors. J Jpn Soc Cancer Ther 23: 2709–2731Google Scholar
  15. 15.
    Arakawa K (1989) An immunological and clinical evaluation of combinated TAE-LAK adoptive immunotherapy. Jpn J Gastroenterol 86: 1494–1506Google Scholar
  16. 16.
    Hirai K, Kawazoe Y, Yamashita K, Kumagai M, Tanaka T, Sakai T, Inoue R, Eguchi S, Majima Y, Abe M, Toyonaga K, Tanikawa K (1986) Transcatheter partial splenic arterial embolization in patients with hypersplenism: A clinical evaluation as supporting therapy for hepatocellular carcinoma and liver cirrhosis. Hepato gastroenterology 33: 105–108PubMedGoogle Scholar
  17. 17.
    Majima Y (1984) Growth rate of hepatocellular carcinoma by ultrasonography and its clinical significance. Acta Hepatologica Japonica 25: 754–765CrossRefGoogle Scholar
  18. 18.
    Taketa K, Sekiya C, Namiki M, Akamatsu K, Ohta Y, Endo Y, Kosaka K (1990) lectin-reactive profiles of alpha-fetoprotein characterizing hepatocellular carcinoma and related conditions. Gastroenterology 99: 508–518PubMedGoogle Scholar

Copyright information

© Springer-Verlag Tokyo 1992

Authors and Affiliations

  • Kyuichi Tanikawa
    • 1
  1. 1.Second Department of MedicineKurume University School of MedicineKurumeJapan

Personalised recommendations