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Influence of lipiodolization on a cirrhotic liver
Author(s) -
Nishizaki Takashi,
Takenaka Kenji,
Ikeda Toshihiko,
Yoshida Kisaku,
Sugimachi Keizo
Publication year - 1995
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.2930580413
Subject(s) - medicine , gastroenterology , general surgery
Lipiodolization—selective regional cancer chemotherapy using Lipiodol plus an anticancer drug (LPD)—can prolong survival time of patients with an unresectable hepatocellular carcinoma (HCC). To enhance understanding of LPD's influence on the cirrhotic liver, we carried out related studies. Forty‐three cirrhotic patients with HCC were treated with LPD (epirubicin in a dose of 15–40 mg/m 2 and Lipiodol of 0.02–0.25 ml/kg). Seven cirrhotic patients with HCC were subjected to hepatic angiography alone, and these subjects selected randomly served as controls. Among the 43 treated with LPD, 23 belonged to Child's class A, 15 to class B, and 5 to class C. Blood samples were taken before angiography (pre) and at 24 hours after angiography (post) from each patient. Post/pre ratio of the following parameters were compared between patients of the two groups: sGOT, sGPT, and LDH as a marker for hepatocyte injury; t. bilirubin and hepaplastin test (HPT) as hepatocyte function; alkaline phosphatase and γ‐GTP to examine bile duct injury; and serum hyaluronic acid level to determine an endothelial cell functions. Post/pre ratio of serum GOT, GPT, LDH levels, and HPT in patients treated with vs. without LPD were 1.32 ± 0.59 vs. 0.92 ± 0.09 ( P < 0.001), 1.18 ± 0.43 vs. 0.88 ± 0.09 ( P < 0.001), 1.11 ± 0.20 vs. 1.00 ± 0.07 ( P < 0.05), and 0.95 ± 0.10 vs. 1.09 ± 0.12 ( P < 0.01), respectively. There were no significant differences in post/pre LPD ratio of other parameters, rates of complications, and hospital stay after LPD for patients with Child's class A, B, and C. Hepatocytes are apparently the primary site of injury in cases of LPD. LPDs, using epirubicin in a dose of 15–40 mg/m 2 and Lipiodol in a dose of 0.02–0.25 ml/kg, proved to be safe for cirrhotic patients with HCC. © 1995 Wiley‐Liss, Inc.