平田 真美¹, 西村 庸夫²

Mami HIRATA¹, Nobuo NISHIMURA²

¹松山城東病院内科, ²松山市民病院内科

¹Department of Internal Medicine, Matsuyama Joutou Hospital, ²Department of Internal Medicine, Matsuyama Shimin Hospital

キーワード : HCC, PEIT, Recurrence, Septum

The efficacy of percutaneous ethanol injection therapy (PEIT) for hepatocellular carcinoma (HCC) is widely accepted, and a complete response is most likely with tumors less than 3 cm in diameter. However, tumor recurrence is often reported in longterm follow up. Recurrence of the primary lesion may be influenced not only by the ethanol dose delivered but also by the presence or absence of a tumor septum. An intratumor septum can be recognized by abdominal ultrasonography (US) if the tumor is larger than 1.5 cm in diameter. In the group of patients with tumors having a recognizable septum, and recurrence occurred at a high incidence. When the injected volume of ethanol was less than twice the estimated tumor volume, the incidence of recurrence of the primary lesion increased, but it also occurred in 20% of the patients injected with more than twice the tumor volume of ethanol. An intratumor septum was recognizable in 70% of such patients. This means that the first treatment should be completely curative when an intratumor septum is detected by US. Interdisciplinary therapy should also be developed to prevent recurrence of the primary lesion.