[Chemoembolization of hepatocellular carcinoma--computed tomographic follow-up observation]

The prognosis of unresectable hepatocellular carcinomas is bad. Untreated, survival is 1.6 to 2.5 months. Systemic chemotherapy has little effect and is associated with marked side effects. Tumour cells are supplied almost exclusively by the hepatic artery, whereas normal liver tissue is supplied by the hepatic artery and portal vein. Consequently, interruption of arterial blood flow results in damage to the carcinoma without affecting the rest of the liver. Lipiodol is an oily contrast medium which is taken up selectively by the tumour and can be demonstrated in tumour, in the interstitium and in blood vessels. We used lipiodol emulsified with cisplatin and epirubicin successfully in 22 patients with inoperable liver cell carcinomas. The treatment was well tolerated, apart from some nausea and mild upper abdominal discomfort. Survival time from first diagnosis and the first embolisation was ten months longer than expected survival or that following systemic chemotherapy.