Abstract
Forty-three patients with hepatocellular carcinomas (HCCs) who had undergone subsegmental transcatheter arterial embolization (sTAE) as initial treatment were studied retrospectively to evaluate the prognosis, recurrence, and effect of sTAE on liver function. Frequent recurrences were observed (disease-free survival rates were 51.2% at 1 year and 7.7% at 3 years), and in the recurrent nodules, 66.4% were distant recurrences. No significant difference was observed in the periods of distant recurrence compared with local recurrence, and also in the periods of distant recurrence with and without local recurrence, implying that strict control of the primary lesion did not prevent distant recurrence. Concerning the effect of sTAE on liver function, ALT and LDH were significantly elevated and albumin was significantly reduced after sTAE (p = 0.002, > 0.0001, and = 0.0009, respectively). But 4 weeks after sTAE, all these levels recovered to their previous values. Moreover transient hepatic reserve reduction after sTAE did not affect the prognosis. In conclusion, for HCCs with such levels of recurrence, strict follow-up and repeat treatments with minimum damage to the hepatic reserve are essential. sTAE is an appropriate and reasonable treatment for such HCCs because of low levels of damage to the hepatic reserve and the possibility of repeat operations. Using sTAE as the main treatment against HCC, survival rates of more than 70% at 3 years were achieved.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Kobayashi K, Sugimoto T, Makino H, Kumagai M, Unoura M, Tanaka N, Kato Y, Hattori N (1985) Screening methods for early detection of hepatocellular carcinoma. Hepatology 5:1100–1105
Unoura M, Kaneko S, Matsushita E, Shimoda A, Takeuchi M, Adachi H, Kawai H, Urabe T, Yanagi M, Matsui O (1993) High-risk groups and screening strategies for early detection of hepatocellular carcinoma in patients with chronic liver disease. Hepatogastroenterology 40:305–310
Allison DJ, Jordan H, Hennessy O (1985) Therapeutic embolisation of the hepatic artery: a review of 75 procedures. Lancet 1:595–599
Chuang VP, Wallace S (1981) Hepatic artery embolization in the treatment of hepatic neoplasms. Radiology 140:51–58
Vetter D, Wenger JJ, Bergier JM, Doffoel M, Bockel R (1991) Transcatheter oily chemoembolization in the management of advanced hepatocellular carcinoma in cirrhosis: results of a Western comparative study in 60 patients. Hepatology 13:427–433
Wheeler PG, Melia W, Dubbins P, Jones B, Nunnerley H, Johnson P, Williams R (1979) Non-operative arterial embolisation in primary liver tumours. Br Med J 2:242–244
Yamada R, Sato M, Kawabata M, Nakatsuka H, Nakamura K, Takashima S (1983) Hepatic artery embolization in 120 patients with unresectable hepatoma. Radiology 148:397–401
Groupe d’Etude et de Traitement du Carcinome Hepatocellulaire (1995) A comparison of lipiodol chemoembolization and conservative treatment for unresectable hepatocellular carcinoma. N Engl J Med 332:1256–1261
Bronowicki JP, Vetter D, Dumas F, Boudjema K, Bader R, Weiss AM, Wenger JJ, Boissel P, Bigard MA, Doffoel M (1994) Transcatheter oily chemoembolization for hepatocellular carcinoma. A 4-year study of 127 French patients. Cancer 74:16–24
Kasugai H, Kojima J, Tatsuta M, Okuda S, Sasaki Y, Imaoka S, Fujita M, Ishiguro S (1989) Treatment of hepatocellular carcinoma by transcatheter arterial embolization combined with intraarterial infusion of a mixture of cisplatin and ethiodized oil. Gastroenterology 97:965–971
Liu CL, Fan ST (1997) Nonresectional therapies for hepatocellular carcinoma. Am J Surg 173:358–365
Nakamura H, Hashimoto T, Oi H, Sawada S (1989) Transcatheter oily chemoembolization of hepatocellular carcinoma. Radiology 170:783–786
Pelletier G, Roche A, Ink O, Anciaux ML, Derhy S, Rougier P, Lenoir C, Attali P, Etienne JP (1990) A randomized trial of hepatic arterial chemoembolization in patients with unresectable hepatocellular carcinoma. J Hepatol 11:181–184
Matsui O, Kadoya M, Yoshikawa J, Gabata T, Arai K, Demachi H, Miyayama S, Takashima T, Unoura M, Kogayashi K (1993) Small hepatocellular carcinoma: treatment with subsegmental transcatheter arterial embolization. Radiology 188:79–83
Kan Z, Ivancev K, Hagerstrand I, Chuang VP, Lunderquist A (1989) In vivo microscopy of the liver after injection of Lipiodol into the hepatic artery and portal vein in the rat. Acta Radiol 30:419–425
Nakamura H, Hashimoto T, Oi H, Sawada S (1988) Iodized oil in the portal vein after arterial embolization. Radiology 167:415–417
Nakamura H, Hashimoto T, Oi H, Sawada S, Furui S, Mizumoto S, Monden M (1990) Treatment of hepatocellular carcinoma by segmental hepatic artery injection of adriamycin-in-oil emulsion with overflow to segmental portal veins. Acta Radiol 31: 347–349
Murakami R, Yoshimatsu S, Yamashita Y, Sagara K, Arakawa A, Takahashi M (1994) Transcatheter hepatic subsegmental arterial chemoembolization therapy using iodized oil for small hepatocellular carcinomas. Correlation between lipiodol accumulation pattern and local recurrence. Acta Radiol 35:576–580
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2000 Springer Japan
About this paper
Cite this paper
Shirota, Y. et al. (2000). Treatment with Subsegmental Transcatheter Arterial Embolization for Hepatocellular Carcinoma: Prognosis, Recurrence, and Effect on Liver Function. In: Okita, K. (eds) Progress in Hepatocellular Carcinoma Treatment. Springer, Tokyo. https://doi.org/10.1007/978-4-431-67913-4_5
Download citation
DOI: https://doi.org/10.1007/978-4-431-67913-4_5
Publisher Name: Springer, Tokyo
Print ISBN: 978-4-431-67983-7
Online ISBN: 978-4-431-67913-4
eBook Packages: Springer Book Archive