[Liver resection after transcatheter hepatic arterial chemoembolization for hepatocellular carcinoma and curative...

To study the therapeutic result of hepatic resection for those hepatocellular carcinoma (HCC) shrunked after transcatheter hepatic arterial chemoembolization (TACE) in the patients with unresectable HCC, authors reported 59 patients with HCC. Among the 59 patients, the maximum diameter of the tumor was 5.6 to 20.0 cm prior to the first TACE, mean 9.43 cm. The patients underwent 1 to 6 times of TACE, mean 2.9 times. The tumor diameters were reduced to 3.29 cm prior to operations. The duration between the last TACE treatment and sequential resection varied from 1 to 7 months, mean 2.53 months. Of the 59 patients, 35 patients' serum alpha-fetoprotein (AFP) levels were elevated. AFP levels returned to normal after TACE treatment in 13 patients. Of the patients, liver segmentectomy, combined liver segmentectomy or partial liver resection was performed in 56 patients, left trilobectomy in 2 and left hemihepatectomy in 1. Tumor necrosis ranged from 40% to 100% pathologically and complete tumor necrosis occurred in 9 patients. Of the 13 patients with AFP levels decreased to normal, 9 still had microscopic living tumor foci. The 1-, 3- and 5- year survival rates were 79.7%, 65% and 56%, respectively. These results indicated that TACE treatment can provide chance of tumor resection for those patients with unresectable HCC and good results can be obtained.