[Hepatectomy after transcatheter arterial embolization (TAE) for hepatocellular carcinomas]

Subjects of this study were 26 patients with hepatocellular carcinoma who underwent hepatectomy after TAE. They did not develop serious complications due to TAE. A suitable interval between TAE and the planned hepatectomy was about one month, based on AFP levels and the recovery of liver functions. Hepatic arteriography after TAE was useful to observe changes of the blood flow into the liver and the carcinoma, as well as to find intrahepatic metastases. It is also necessary for making final decisions on the strategy of the hepatectomy. The effects of TAE greatly depended on patterns of arterial blood feeding. When the tumor was less than 5 cm in diameter, had a capsule, and was fed by a single artery the necrotic rate was high. TAE was effective in intrahepatic metastases 0.5 cm or more in diameter, which were detectable by hepatic arteriography. TAE had little effect on intrahepatic metastases less than 0.5 cm in diameter, on intracapsular or extracapsular invasion, or on tumor embolus. For tumor embolus in the portal vein, since TAE and hepatectomy give poor results, other methods should be considered.