[Postoperative histologic evaluation of hepatocarcinoma treated using chemo-embolization]

Transcatheter arterial chemoembolization (TAE) is generally considered to be an effective palliative treatment in patients with inoperable hepatocellular carcinoma (HCC). Recently, TAE has also been performed on operable cases, in order to reduce the chances of recurrence. This study was aimed at evaluating the histopathologic changes following chemoembolization in surgically resected HCCs. Chemoembolization was performed by selective intra-arterial injection of Lipiodol-chemotherapeutic agent (Adriamycin), followed by terminal embolization with Spongostan, in 5 patients with operable HCC. All patients underwent Computed Tomography (CT) follow-up and subsequent partial hepatectomy. CT after chemoembolization accurately demonstrated no increase in tumor size in all patients. In all HCCs a thick fibrous capsule was found. Histopathology of the surgically resected HCCs demonstrated complete necrosis of the primary tumor in 4/5 cases; 1 HCC remained viable and tumor cells were found in a few daughter nodules surrounding the tumor. In 1 case there were viable tumor emboli in the small portal vessels around the tumor. In patients with resectable HCC, TAE was useful in preventing tumor growth and in thickening the capsule, thus making surgery safer and reducing the chances of recurrence.