1.The Attempt to Develop a "Model Program" on the Basis of the Objectives Established by the Ministry of Health, Labour and Welfare in the New Postgraduate Clinical Training System
Kazuhiko KIKAWA ; Masahiro TANABE ; Kiyoshi KITAMURA ; Hayato KUSAKA ; Masamune SHIMO ; Katsusada TAKAHASHI ; Yujiro TANAKA ; Tadashi MATSUMURA ; Takao MORITA ; Kunihiko MATSUI ; Takashi OHBA ; Hirotsugu KOHROGI ; Osamu SHIMODA ; Taichi TAKEDA ; Junichi TANIGUCHI ; Tatsuya TSUJI ; Hiroyuki HATA
Medical Education 2006;37(6):367-375
Clinical training programs play an extremely important role in the new postgraduate clinical training system introduced in 2004 because facilities for clinical training now include various health-related institutions in addition to the university hospitals and special hospitals for clinical training used in the previous system. Although educational goals have been established by the Ministry of Health, Labour and Welfare, trainees may have difficulty achieving these goals, even under the guidance of staff at the various facilities. There are differences in the function and quality of health-related institutions in the community. For the practical and convenient application of educational goals, we have attempted develop a “model program” to supplement the objectives indicated by the learning goals with more specific objectives. These supplementary objectives can be modified by individual institutions. We hope that this “model program” contributes to the development of objectives for each institution and helps improve the quality of the postgraduate training system in Japan.
2.Treatment options for solitary hepatocellular carcinoma ≤5 cm: surgery vs. ablation: a multicenter retrospective study
Kazuya KARIYAMA ; Kazuhiro NOUSO ; Atsushi HIRAOKA ; Hidenori TOYODA ; Toshifumi TADA ; Kunihiko TSUJI ; Toru ISHIKAWA ; Takeshi HATANAKA ; Ei ITOBAYASHI ; Koichi TAKAGUCHI ; Akemi TSUTSUI ; Atsushi NAGANUMA ; Satoshi YASUDA ; Satoru KAKIZAKI ; Akiko WAKUTA ; Shohei SHIOTA ; Masatoshi KUDO ; Takashi KUMADA
Journal of Liver Cancer 2024;24(1):71-80
Background:
/Aim: The aim of this study was to compare the therapeutic efficacy of ablation and surgery in solitary hepatocellular carcinoma (HCC) measuring ≤5 cm with a large HCC cohort database.
Methods:
The study included consecutive 2,067 patients with solitary HCC who were treated with either ablation (n=1,248) or surgery (n=819). Th e patients were divided into three groups based on the tumor size and compared the outcomes of the two therapies using propensity score matching.
Results:
No significant difference in recurrence-free survival (RFS) or overall survival (OS) was found between surgery and ablation groups for tumors measuring ≤2 cm or >2 cm but ≤3 cm. For tumors measuring >3 cm but ≤5 cm, RFS was significantly better with surgery than with ablation (3.6 and 2.0 years, respectively, P=0.0297). However, no significant difference in OS was found between surgery and ablation in this group (6.7 and 6.0 years, respectively, P=0.668).
Conclusion
The study suggests that surgery and ablation can be equally used as a treatment for solitary HCC no more than 3 cm in diameter. For HCCs measuring 3-5 cm, the OS was not different between therapies; thus, ablation and less invasive therapy can be considered a treatment option; however, special caution should be taken to prevent recurrence.