[Preoperative chemo-embolization for liver cell cancer]

Transcatheter arterial chemo-embolization (chemo-embolization) for treatment of unresectable liver cell cancer has now been widely used. Histological appraisal of chemo-embolization had been reported by us and many of cancers thus treated fell into complete necrosis. The present report deals with histological examination on 14 resected specimen of hepatocellular cancer in order to clarify the prevention from intrahepatic spread and therefore to elucidate the justification of preoperative chemo-embolization. One year actuarial survival rate of chemo-embolization followed by hepatic resection was 83%, while that of hepatic resection was 46% and that of chemo-embolization was 59%. Capsular invasion was observed in 83% of cases, but complete necrosis of the capsular invasion was seen in 60% of cases. Eighty-three percent of small cancer, less than 5 cm in diameter, showed completed necrosis of the capsular invasion. This necrotizing effect is beneficial for prevention from the recurrence of the resected stump when local excision is underwent in high risk patients. But once the bulky tumor emboli embedded and grew extensively in the portal vein, they could not be erased .