Small hepatocellular carcinoma: treatment with subsegmental transcatheter arterial embolization

The effectiveness of subsegmental transcatheter arterial embolization (TAE) therapy for small hepatocellular carcinomas (HCCs) was retrospectively analyzed. TAE was performed in 100 patients with liver cirrhosis. There was a total of 124 nodular-type HCCs less than 4 cm in diameter. TAE was performed by injecting a mixture of iodized oil and anticancer drugs followed by gelatin sponge particles or a mixture of iodized oil and absolute ethanol into the more distal branches of the subsegmental artery. Complete necrosis was seen at histologic examination in seven of 11 resected lesions. Among the remaining 113 lesions in 90 patients followed up without surgery, the 1-and 4-year local recurrence rates after TAE were 18% and 33%, respectively. The 1- and 4-year survival rates for 82 patients with Child class A or B disease were 100% and 67%, respectively. No substantial deterioration of liver function was observed. Subsegmental TAE improved the prognosis of the patients with liver cirrhosis associated with small HCCs.