[Transcatheter chemoembolization combined with hepatectomy for primary hepatic carcinoma. A clinical and pathological...

Transcatheter chemoembolization (TCE) followed by laparotomy was performed in 12 patients with primary hepatic carcinoma (HCC). Each patient received TCE for 1-5 times with an interval of 4-6 weeks. The embolizing reagents included mitomycin C (20-40 mg), adriamycin (20-60 mg) and 40% lipiodol (2-10 ml). Results showed that the AFP level remarkably decreased even became normal and tumor size reduced. Partial hepatectomy was carried out in all 12 patients undergoing laparotomy except one with extensive abdominal metastasis. Histopathological study showed tissue necrosis and fibrosis at different stages in the surrounding liver parenchyma especially in the tumour area. Apart from sclerotic lesions, one or two daughter nodules were found in 2 patients. residual liver cancer was found in all of the 11 patients. Reexploration was made one year after liver resection in one patient for local recurrence and metastasis. The other two with right lung metastatic tumour 4-6 months after operation were given transcatheter pulmonary arterial embolization. We consider TCE as an effective adjuvant therapy to the combined treatment of liver carcinoma. It is suggested that TCE is indicated for unresectable HCCs, resectable HCCs with poor liver function, those associated with portal hypertension, and recurrent HCCs.