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Chemoembolization of hepatocellular carcinoma in patients who undergo liver transplantation
C Spreafico1, A Marchianò, E Regalia
1Department of Radiology, National Cancer Institute of Milan, Italy.
Purpose:
To determine the efficacy of chemoembolization (CHE) for hepatocellular carcinoma (HCC) in patients with a cirrhotic liver.
Materials And Methods:
Twenty-one patients with cirrhosis and 33 HCC nodules received a mean of 2.4 cycles of CHE before orthotopic liver transplantation (OLT). Iodized oil plus doxorubicin (13 patients) or mitoxantrone (eight patients) was injected into the hepatic artery. Twelve (57%) of the patients underwent terminal embolization with gelatin sponge pledgets. After OLT, the percentage of tumor necrosis was assessed in each HCC nodule.
Results:
Twelve (36%) of 33 HCC nodules responded completely to CHE (necrosis > 90%). Successful treatment was statistically significantly related to nodular diameter greater than 2 cm (P = .03), solitariness (P = .0009), hypervascularity (P = .001), and good retention of iodized oil (P = .05). Seven (33%) of the patients had major complications; no death occurred in association with CHE. All patients survived OLT; in three patients (14%), HCC recurred a median of 21 months after OLT.
Conclusion:
CHE seems to be an effective treatment for HCC in patients with liver cirrhosis who await OLT.