Chemoembolization of hepatocellular carcinoma in patients who undergo liver transplantation.
OBJECTIVE
To determine the efficacy of chemoembolization (CHE) for hepatocellular carcinoma (HCC) in patients with a cirrhotic liver.


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.


CONCLUSIONS
CHE seems to be an effective treatment for HCC in patients with liver cirrhosis who await OLT.
Spreafico
C
C
Department of Radiology, National Cancer Institute of Milan, Italy.
Marchianò
A
A
Regalia
E
E
Frigerio
L F
LF
Garbagnati
F
F
Andreola
S
S
Milella
M
M
Lanocita
R
R
Mazzaferro
V
V
D015901:Angiography, Digital Subtraction; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D003131:Combined Modality Therapy; D006801:Humans; D008099:Liver / Q000098:blood supply; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D016031:Liver Transplantation; D008875:Middle Aged; D015641:Radiography, Interventional