A Prospective Randomized Trial of the Preventive Effect of Pre-operative Transcatheter Arterial Embolization against Recurrence of Hepatocellular Carcinoma

• Published in: Cancer science Vol. 87; no. 2; pp. 206 - 211
• Main Authors: Yamasaki, Susumu, Hasegawa, Hiroshi, Kinoshita, Hiroaki, Furukawa, Masato, Imaoka, Shingi, Takasaki, Ken, Kakumoto, Youichiro, Saitsu, Hideki, Yamada, Ryusaku, Oosaki, Yukio, Arii, Shigeki, Okamoto, Eizo, Monden, Morito, Ryu, Munemasa, Kusano, Shouichi, Kanematsu, Takashi, Ikeda, Kenji, Yamamoto, Masayuki, Saoshiro, Takeo, Tsuzuki, Toshiharu
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.02.1996; Japanese Cancer Association; John Wiley & Sons, Inc
• Subjects: Adult; Biological and medical sciences; Carcinoma, Hepatocellular - therapy; Combined Modality Therapy; Diseases of the digestive system; Embolization; Embolization, Therapeutic - methods; Hepatectomy; Hepatocellular carcinoma; Humans; Liver cancer; Liver Neoplasms - therapy; Medical sciences; Metastases; Middle Aged; Pre-operative TAE; Prospective Studies; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Recurrence; Surgery; Survival; Survival Analysis; Survival rate; Thrombosis; Hepatic artery; Human; Relapse; Prognosis; Instrumentation therapy; Hepatic disease; Malignant tumor; Hepatectomy; Treatment; Liver cell carcinoma; Surgery; Digestive diseases; Embolization; Preoperative
• ISSN: 0910-5050; 1347-9032; 1349-7006; 1876-4673
• DOI: 10.1111/j.1349-7006.1996.tb03160.x

To clarify whether pre‐operalive transcatheter arterial embolization (TAE) improves survival after hepatectomy, a prospective randomized comparative study was done. Of a total of 115 registered patients having solitary hepatocellular carcinoma (HCC) 2 to 5 cm in diameter, 18 (15.7%) were excluded after randomization. As a result, 97 patients were chosen as subjects and divided into two groups: hepatectomy with (group A: n = 50) and without (group B: n=47) pre‐operative TAE. The period of observation of the patients who survived the surgery was between 4.0 and 6.6 years. The randomization appeared to have provided well‐balanced groups of patients and the clinico‐pathological characteristics of the two groups were quite similar. The necrotic part of the cancerous lesions, as confirmed by operative specimens, amounted to 74.8 ±33.4% (mean±SD) in group A and 6.8 ±7.2% in group B (P<0.01). However, the cancer‐free survival rates after hepatectomy in both groups showed little difference (39.1±7.0 (%±SE) and 31.1±0.1, respectively). We speculate that TAE is not effective against such HCC accessory lesions as minute intrahepatic metastasis and tumor thrombus and that pre‐operative TAE does not improve post‐operative survival.