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Re‐evaluation of lipiodolized transarterial chemoembolization therapy for intrahepatic recurrence of hepatocellular carcinoma after curative liver resection
Author(s) -
Eguchi Susumu,
Matsumoto Shigehiro,
Hamasaki Koji,
Takatsuki Mitsuhisa,
Hidaka Masaaki,
Tajima Yoshitsugu,
Sakamoto Ichiro,
Kanematsu Takashi
Publication year - 2008
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s00534-007-1341-3
Subject(s) - medicine , hepatocellular carcinoma , gastroenterology , resection , hazard ratio , multivariate analysis , hepatectomy , parenchyma , radiology , surgery , pathology , confidence interval
Background/Purpose While lipiodolized transarterial chemoembolization (lip‐TACE) is effective for treating unresectable hepatocellular carcinoma (HCC), its effect for treating recurrent HCC after curative liver resection needs to be clarified. Methods Of 163 patients who had undergone curative liver resection between 1992 and December 2003, 65 patients (39.8%) had recurrent HCC in the liver without extrahepatic recurrence and were indicated for lip‐TACE. The overall survival rate after lip‐TACE was calculated, and its correlation with factors such as the histology of the primary HCC and background noncancerous tissue were analyzed. Results The overall survival rates after lip‐TACE after the detection of the first recurrent HCC were 82.6%, 44.5%, and 24.8% at 1, 3, and 5 years, respectively. The factors affecting patient survival after lip‐TACE were microscopic portal venous involvement of HCC at liver resection, grade of inflammation in the noncancerous liver parenchyma, and recurrence within 1 year after the initial liver resection. Multivariate analysis showed that the period between the resection and first recurrence had the highest hazard ratio. Conclusions Lip‐TACE is a reasonable procedure for treating recurrent HCC in selected patients who are not eligible for hepatic re‐resection. When HCC recurred within 1 year from the primary liver resection, the effect of lip‐TACE on patient survival was limited.