title: Chemoembolization and percutaneous ethanol injection for intrahepatic recurrence of hepatocellular carcinoma after hepatic resection.
abstract: OBJECTIVE
  Management of 36 patients who developed intrahepatic recurrence (IHR) after curative hepatic resection for hepatocellular carcinoma (HCC) was studied.
  
  
  METHODS
  IHRs were classified into type I with a solitary lesion (n = 16), type II with 2-4 lesions (n = 11), and type III with > or = 5 lesions (n = 11).
  
  
  RESULTS
  Periodic angiography and Lipiodol CT first detected IHRs in six patients. Most IHRs in type I and II were smaller than 20 mm. Thirty-three patients underwent regional treatments including transarterial infusion of Lipiodol containing anticancer drugs (TAIL) (n = 19), combined TAIL and percutaneous ethanol injection PEI (n = 12), surgery (n = 3), and PEI (n = 1). Post-recurrence 5-yr survival rate of type I (51%) was higher than that of type II (0%) or III (0%) (p < 0.01). Of the 27 patients with type I and II recurrences, seven became tumor-free for 11-67 months after regional treatments including TAIL + PEI (n = 5), TAIL (n = 1), and surgery (n = 1); 13 developed multiple IHRs.
  
  
  CONCLUSIONS
  Postoperative close follow-up with qualified imaging and vigorous treatments prolong the survival of the patients with HCC who developed IHRs. Type I or type II IHR can be curable with the combination of TAIL and PEI or repeated surgery.
authors.affiliation: Department of Surgery II, Faculty of Medicine, University of Ehime, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Sato
authors.forename: Y
authors.initials: Y
authors.lastname: Watanabe
authors.forename: N
authors.initials: N
authors.lastname: Iseki
authors.forename: S
authors.initials: S
authors.lastname: Ueda
authors.forename: K
authors.initials: K
authors.lastname: Kawach
authors.forename: S
authors.initials: S
authors.lastname: Kimura
authors.forename: Y
authors.initials: Y
authors.lastname: Itoh
authors.forename: K
authors.initials: K
authors.lastname: Ohkubo
authors.forename: M
authors.initials: M
authors.lastname: Onji
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D016461:Chemoembolization, Therapeutic; D003287:Contrast Media; D004337:Drug Carriers; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D015552:Injections, Intralesional; D007459:Iodized Oil / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D003287:Contrast Media; D004337:Drug Carriers; D000431:Ethanol; D007459:Iodized Oil