Pathological evaluation of hepatic dearterialization in encapsulated hepatocellular carcinoma

Specimens of encapsulated hepatocellular carcinoma from 48 patients who had received no previous treatment and from six patients previously treated by hepatic arterial interruption by embolization or ligation were obtained by resection and examined for incidence and extent of necrosis of the tumor. Among the 48 specimens from the non-pre-treated patients, 25 tumors were smaller than 5 cm and showed no notable necrosis; of the 23 remaining tumors--which were larger than 5 cm--12 (52%) showed spontaneous central necrosis. The necrosis rate of the tumor ranged from 10% to 40%. In contrast, in six specimens from pretreated cases, more than 60% of the tumors were found to be necrotic. Two tumors smaller than 5 cm were completely necrotized by embolization. The findings indicated the significance of hepatic dearterialization for the management of encapsulated hepatocellular carcinoma. Daughter nodules, however, were found to have escaped necrosis.