title: Sequential transarterial chemoembolization for unresectable advanced hepatocellular carcinoma.
abstract: OBJECTIVE
  The aim of this prospective study was to evaluate the feasibility, safety, and efficacy of sequential transarterial chemoembolization (TACE) for patients with unresectable advanced hepatocellular carcinoma (HCC).
  
  
  METHODS
  Twenty-one consecutive patients with unresectable T3 and T4 HCC were treated by sequential TACE (median time interval between treatments 7 weeks) up to six times with an emulsion of lipiodol, epirubicin, and cisplatin. All TACE procedures were performed as unilobar or whole-liver chemoembolization.
  
  
  RESULTS
  An average of 3.9 TACE procedures were performed per patient. One primary and two secondary technical failures occurred. No procedural death was observed. After exclusion of the patient with the primary technical failure and 3 patients with extrahepatic disease, the survival rates for the remaining 17 patients at 6, 12, 18, and 24 months were 70.6%, 52.9%, 44.1%, and 33.1%, respectively.
  
  
  CONCLUSIONS
  Sequential TACE is a safe procedure in patients with unresectable advanced HCC and feasible in most cases. It seems to prolong the survival time compared with historical series of untreated patients.
authors.affiliation: Department of Diagnostic Radiology, City Hospital Dortmund, Germany.
authors.forename: H J
authors.initials: HJ
authors.lastname: Jaeger
authors.forename: U M
authors.initials: UM
authors.lastname: Mehring
authors.forename: F
authors.initials: F
authors.lastname: Castañeda
authors.forename: F
authors.initials: F
authors.lastname: Hasse
authors.forename: G
authors.initials: G
authors.lastname: Blumhardt
authors.forename: D
authors.initials: D
authors.lastname: Loehlein
authors.forename: K D
authors.initials: KD
authors.lastname: Mathias
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D002945:Cisplatin / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D015251:Epirubicin; D007459:Iodized Oil; D002945:Cisplatin