title: A prospective randomized trial of the preventive effect of pre-operative transcatheter arterial embolization against recurrence of hepatocellular carcinoma.
abstract: To clarify whether pre-operative transcatheter arterial embolization (TAE) improves survival after hepatectomy, a prospective randomized comparative study was done. Of a total of 115 registered patients having solitary hepatocellular carcinoma (HCC) 2 to 5 cm in diameter, 18 (15.7%) were excluded after randomization. As a result, 97 patients were chosen as subjects and divided into two groups: hepatectomy with (group A: n=50) and without (group B: n=47) pre-operative TAE. The period of observation of the patients who survived the surgery was between 4.0 and 6.6 years. The randomization appeared to have provided well-balanced groups of patients and the clinico-pathological characteristics of the two groups were quite similar. The necrotic part of the cancerous lesions, as confirmed by operative specimens, amounted to 74.8+/-33.4% (mean +/-SD) in group A and 6.8+/-7.2% in group B (P<0.01). However, the cancer-free survival rates after hepatectomy in both groups showed little difference (39.1+/-7.0 (%+/-SE) and 31.1+/-0.1, respectively). We speculate that TAE is not effective against such HCC accessory lesions as minute intrahepatic metastasis and tumor thrombus and that pre-operative TAE does not improve post-operative survival.
authors.affiliation: Department of Surgical Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Yamasaki
authors.forename: H
authors.initials: H
authors.lastname: Hasegawa
authors.forename: H
authors.initials: H
authors.lastname: Kinoshita
authors.forename: M
authors.initials: M
authors.lastname: Furukawa
authors.forename: S
authors.initials: S
authors.lastname: Imaoka
authors.forename: K
authors.initials: K
authors.lastname: Takasaki
authors.forename: Y
authors.initials: Y
authors.lastname: Kakumoto
authors.forename: H
authors.initials: H
authors.lastname: Saitsu
authors.forename: R
authors.initials: R
authors.lastname: Yamada
authors.forename: Y
authors.initials: Y
authors.lastname: Oosaki
authors.forename: S
authors.initials: S
authors.lastname: Arii
authors.forename: E
authors.initials: E
authors.lastname: Okamoto
authors.forename: M
authors.initials: M
authors.lastname: Monden
authors.forename: M
authors.initials: M
authors.lastname: Ryu
authors.forename: S
authors.initials: S
authors.lastname: Kusano
authors.forename: T
authors.initials: T
authors.lastname: Kanematsu
authors.forename: K
authors.initials: K
authors.lastname: Ikeda
authors.forename: M
authors.initials: M
authors.lastname: Yamamoto
authors.forename: T
authors.initials: T
authors.lastname: Saoshiro
authors.forename: T
authors.initials: T
authors.lastname: Tsuzuki
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000379:methods*; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy*; D008875:Middle Aged; D011446:Prospective Studies; D016019:Survival Analysis