Nanashima A, Masuda J, Miuma S, Sumida Y, Nonaka T, Tanaka K, Hidaka S, Sawai T, Nagayasu T. Selection of treatment modality for hepatocellular carcinoma according to the modified Japan Integrated Staging score. World J Gastroenterol 2008; 14(1): 58-63 [PMID: 18176962 DOI: 10.3748/wjg.14.58]
Corresponding Author of This Article
Atsushi Nanashima, MD, Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan. a-nanasm@alpha.med.nagasaki-u.ac.jp
Article-Type of This Article
Rapid Communication
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Atsushi Nanashima, Yorihisa Sumida, Takashi Nonaka, Kenji Tanaka, Shigekazu Hidaka, Terumitsu Sawai, Takeshi Nagayasu, Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
Junichi Masuda, Second Department of Internal Medicine, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
Satoshi Miuma, First Department of Internal Medicine, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
Correspondence to: Atsushi Nanashima, MD, Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan. a-nanasm@alpha.med.nagasaki-u.ac.jp
Telephone: +81-95-8497304
Fax: +81-95-8497306
Received: July 21, 2007 Revised: November 15, 2007 Published online: January 7, 2008
Abstract
AIM: To compare the prognosis of patients who underwent hepatectomy and ablation using the modified Japan Integrated Staging score (mJIS).
METHODS: We examined the clinicopathologic records and patient outcomes in 278 HCC patients including 226 undergoing hepatectomy and 52 undergoing ablation therapy.
RESULTS: Cirrhosis was more frequent in the ablation group. Tumor size, number and presence of vascular invasion were significantly higher in the operation group compared to the ablation group. The local recurrence rate adjacent to treated lesions was significantly higher in the ablation group compared to the operation group (P < 0.05). The 3- and 5-year survival rates in the ablation and the operation group were 66% and 78%, and 50% and 63%, respectively, but not significantly different. Over 50% survival rates were observed in patients with a mJIS score of 0-2 in both groups. However, survival rates with a score of 3-5 in both groups were significantly lower.
CONCLUSION: According to the mJIS system, both local treatments could be selected for patients with a score of 0-2. However, for patients with a score more than 3, liver transplantation might be a better option in patients with HCC.
