title: Intraarterial chemoembolisation with lipiodol and epirubicin in hepatocellular cancer--improved survival in some patients?
abstract: OBJECTIVE
  Arterial chemoembolisation with lipiodol and a cytotoxic drug is reported to give equivocal results in irresectable primary hepatocellular cancer (HCC). In order to further elucidate the possible response to this treatment, we analysed the results of all patients with irresectable HCC treated with chemoembolisation at our hospital.
  
  
  METHODS
  58 consecutive patients with HCC were treated with lipiodolepirubicin chemoembolisation between February 1988 - October 1994 and followed until death or October 1998.
  
  
  RESULTS
  The average survival was 11.7 months and median survival was 6 months. 17 patients had only one treatment mostly due to death within 6 weeks after the first treatment. Patients with an open portal system at inclusion (50% of all) were found to have significantly increased survival after 6 and 12 months compared to those with portal obstruction. The subgroup of patients displaying a decrease in tumour size as judged by repeated CT scan 6 months after inclusion had significantly increased survival; all survived more than 12 months (median survival 30 months).
  
  
  CONCLUSIONS
  Chemoembolisation with lipiodol-epirubicin may have an impact on survival on selected patients with irresectable hepatocellular cancer. The treatment may justifiably be offered patients with an open portal venous system and without liver failure.
authors.affiliation: Department of Surgery, University Hospital, Uppsala, Sweden. Britt-Marie.Karlson@kirurgi.uu.se
authors.forename: B M
authors.initials: BM
authors.lastname: Karlson
authors.forename: A M
authors.initials: AM
authors.lastname: Löfberg
authors.forename: L E
authors.initials: LE
authors.lastname: Lörelius
authors.forename: G
authors.initials: G
authors.lastname: Jacobson
authors.forename: U
authors.initials: U
authors.lastname: Haglund
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D003287:Contrast Media / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D007459:Iodized Oil / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis
chemical_list: D000903:Antibiotics, Antineoplastic; D003287:Contrast Media; D015251:Epirubicin; D007459:Iodized Oil