Progress of Regional Therapy for Hepatocellular Carcinoma

Abstract There are 2 types of regional therapy for hepatocellular carcinoma(HCC). One is transarterial therapy based on the dual supply of hepatic blood flow and characteristics of hypervascular tumors, and the other is local puncture or ablation therapy using a needle or an electric pole. The latter type of therapy is based on the macroscopic form of HCC, which is localized and nodular. With regard to transarterial therapies, hepatic arterial infusion(HA), ligation of hepatic arteries(dearterialization), and transarterial chemoembolization(TACE)have been developed and improved. At present, TACE with Lipiodol(Lip-TACE) is a first-line therapy for locally advanced HCC. Moreover, with regard to local puncture or ablation therapies, percutaneous ethanol injection(PEI)and microwave coagulation therapy(MCT)-both of which originated in Japan-as well as radiofrequency ablation(RFA)have been developed and improved. At present, the first-line local ablation therapy for relatively earlystage HCC(3 cm or less in diameter and 3 or less tumors)is RFA. A RCT is underway to compare the long-term prognosis of patients with HCC between hepatic resection and RFA.