[Postoperative adjuvant arterial infusion chemotherapy in patients with advanced hepatocellular carcinoma].
Seventy-five surgically treated patients with hepatocellular carcinoma (HCC) of Stage III or IV-A were divided into two groups: group I, control without postoperative adjuvant infusion (PAI); group II, patients treated with PAI. In the PAI group, 29 patients (mean diameter of tumors = 71 mm) prophylactically underwent PAI after hepatic resection. Chemotherapeutic agents, (5-FU, ADM, MMC, CDDP and Lipiodol) were administered 4 times a year via the hepatic artery through Infuse A port. The remaining 46 patients (mean diameter of tumors = 70 mm) served as the historical control without PAI. The 4-year cumulative survival rate was higher in the PAI group (45.6%) than in the control (25.4%, p = 0.0424). The 4-year disease-free survival rate was also improved in the PAI group (37.0%) compared with that in the control (14.4%, p = 0.0096). Intrahepatic multiple recurrence was recognized in 8 out of 29 patients in the PAI group (28%) and in 24 out of 46 in the control (53%, p = 0.036) within 1 year after surgery. Extrahepatic recurrence without diseases in the remnant liver tended to occur with higher frequency in the PAI group than in the control. Based on our data, we suggest that PAI is effective in alleviating intrahepatic multiple recurrence within 1 year after hepatic resection for advanced HCC and that systemic chemotherapy may be necessary for preventing extrahepatic recurrence.
Nakashima
K
K
First Dept. of Surgery, Oita Medical University.
Aramaki
M
M
Kawano
K
K
Yoshida
T
T
Kim
Y I
YI
Kitano
S
S
Kobayashi
M
M
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006498:Hepatectomy; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D007459:Iodized Oil / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000517:prevention & control*; D011182:Postoperative Care; D015996:Survival Rate
D016685:Mitomycin; D007459:Iodized Oil; D004317:Doxorubicin; D002945:Cisplatin; D005472:Fluorouracil