Premium
New treatment for hepatocellular carcinoma
Author(s) -
JOHNSON PHILIP J
Publication year - 1998
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.1998.tb01900.x
Subject(s) - medicine , hepatocellular carcinoma , lipiodol , radiation therapy , carcinoma , pathological , radiological weapon , chemotherapy , surgery , incidence (geometry) , selective internal radiation therapy , hepatectomy , resection , radiology , physics , optics
Although the incidence of hepatocellular carcinoma (HCC) is likely to start falling in many countries following mass vaccination programmes, large numbers of new cases are likely to be seen for many years to come. For the majority of patients, only palliative treatments can be offered. Systemic chemotherapy does not improve survival. Locoregional therapy is widely used and certainly results in a consistent decrease in tumour size, but clear evidence of any improvement in overall survival remains elusive. We have recently described the application of selective internal radiotherapy using 90 yttrium microspheres. Although response rates by conventional radiological criteria were only modest, several initially inoperable cases became operable and subsequent resection revealed complete pathological remission in some. The resection became possible, not only because of tumour shrinkage, but also because of hypertrophy of the non‐tumorous liver. To date, only a small number, probably less than 15% of patients with HCC will be suitable for an attempt at surgical resection and recurrence will occur in more than half of these. We have recently shown that postoperative intra‐arterial administration of Lipiodol I 131 may significantly decrease this recurrence rate.