title: Hepatocellular carcinoma: surgical resection versus surgical resection combined with pre- and post-operative locoregional immunotherapy-chemotherapy. A prospective randomized study.
abstract: Hepatocellular carcinoma remains a disease with poor prognosis. Liver resection, although the optimal method of management, is associated with a high incidence of intrahepatic tumour recurrence ranging between 50-70%, 12 to 18 months following surgery. This study assesses prospectively the results of liver resection as compared to liver resection combined with pre- and post-operative locoregional chemotherapy-immunotherapy in 40 patients suffering from hepatocellular carcinoma. Patients were randomly assigned to two groups. Group A (20 patients) had liver resection only, while Group B (20 patients) had liver resection combined with pre- and past-operative targeting locoregional chemotherapy-immunotherapy. Five (5) patients died in total: two from Group A and two from Group B, during the first 30 days following surgery due to reasons related to the procedure (post-operative liver failure in three, pulmonary embolism in one). The remaining patient from Group A died 10 months following liver resection due to intrahepatic tumour recurrence. From Group A, 17 patients are alive from 3 to 26 months after surgery. Of the 17 alive patients, 10 are free of disease and 7 show intrahepatic recurrence. Thus, tumour intrahepatic recurrence occurred in 8 patients of group A. From Group B, all 18 patients are alive and free of disease from 4 to 27 months after surgery. No patient died because of the disease nor has any patient shown intrahepatic tumour recurrence. As a conclusion of the present results, liver resection combined with pre- and post-operative targeting locoregional immunotherapy-chemotherapy appears to offer substantial advantages for patients undergoing surgery because of hepatocellular carcinoma.
authors.affiliation: Department of Hepatobiliary-Pancreatic Surgery, Hellenic Anticancer Institute, St. Savas Hospital, Athens, Greece.
authors.forename: N J
authors.initials: NJ
authors.lastname: Lygidakis
authors.forename: J
authors.initials: J
authors.lastname: Pothoulakis
authors.forename: A E
authors.initials: AE
authors.lastname: Konstantinidou
authors.forename: H
authors.initials: H
authors.lastname: Spanos
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D016190:Carboplatin / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D002408:Catheters, Indwelling; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003974:Diatrizoate Meglumine; D004334:Drug Administration Schedule; D004337:Drug Carriers; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006498:Hepatectomy / Q000401:mortality; D006499:Hepatic Artery; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007167:Immunotherapy; D007269:Injections, Intra-Arterial; D007371:Interferon-gamma / Q000627:therapeutic use*; D007459:Iodized Oil; D002955:Leucovorin / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009363:Neoplasm Proteins / Q000097:blood; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D011183:Postoperative Complications / Q000401:mortality; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000401:mortality; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D004337:Drug Carriers; D007155:Immunologic Factors; D009363:Neoplasm Proteins; D000509:alpha-Fetoproteins; D003974:Diatrizoate Meglumine; D016685:Mitomycin; D007459:Iodized Oil; D007371:Interferon-gamma; D016190:Carboplatin; D002955:Leucovorin; D005472:Fluorouracil