[Accumulation of lipiodol in hepatocellular carcinoma after transarterial chemoembolization with 5 FU-lipiodol-emulsion].
The selective accumulation of 5FU-Lipiodol-Emulsion (5 FU-Lp-E) in hepatocellular carcinoma (HCC) has been pathologically studied in 31 patients following hepatectomy. Twenty-five out of 31 cases were treated with intrahepatic arterial infusion of 5 FU-Lp-E before the operation and six cases served as a control. The treated group consisted of 20 cases with expansive type, two cases with infiltrative type and three with mixed type of HCC according to Nakashima's classification. The resected specimens were examined by CT, soft X-ray and histology. A retention rate of Lipiodol (Lp) over 75% in the main tumor was seen in 16 patients (64%). The tumors were all smaller than 7.5 cm in diameter, and 14 out of 16 cases were expansive type. On the other hand, a necrotic rate of over 20% in the main tumor possibly due to the therapeutic effect of 5 FU-Lp-E was observed in 15 patients (60%), and 14 out of 15 cases were expansive type. Moreover, a necrotic rate of more than 90% in the main tumor was demonstrated in five cases. All were expansive type of HCC with thick capsule. On histological examination, Lp generally remained more selectively in blood vessels and/or sinusoid-like space in tumor tissues than in any other tissues. As noticed in patients with widespread necrosis of HCC, Lp accumulated more selectively in necrotic tissues than in viable tissues of the tumor. Therefore, it was suggested that transarterial chemoembolization with 5 FU-Lp-E can be more effective in the expansive type than in other types of HCC, and that some expansive types of HCC, especially smaller than 7.5 cm in diameter, might undergo almost complete necrosis by this method.
Okada
K
K
First Dept. of Surgery, Medical College of Oita, Japan.
Tada
I
I
Suzuki
K
K
Kim
Y I
YI
Kobayashi
M
M
D006528:Carcinoma, Hepatocellular / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods; D004655:Emulsions; D005472:Fluorouracil / Q000008:administration & dosage* / Q000627:therapeutic use; D006499:Hepatic Artery; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage / Q000493:pharmacokinetics*; D008113:Liver Neoplasms / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D014018:Tissue Distribution
D004655:Emulsions; D007459:Iodized Oil; D005472:Fluorouracil