Transcatheter arterial chemoembolization for hepatocellular carcinoma in patients with cirrhosis: evaluation of damage to nontumorous liver tissue-long-term prospective study.
OBJECTIVE
To evaluate damage to cirrhotic liver tissue after transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC).


METHODS
TACE was performed in 111 patients with HCC that involved less than 30% of the liver. Baseline liver function was evaluated with Child-Pugh scores and other indicators. Eighty-two patients had Child-Pugh class A disease, 27 had class B disease, and two had class C disease. All patients underwent chemotherapy followed by gelatin sponge particle embolization in the proper ("complete" embolization; n = 69) or right or left main ("partial" embolization; n = 42) hepatic artery. Liver function was assessed 4 months later, and 95 patients underwent a second TACE (complete embolization in 57, partial in 38). Liver function was again assessed 4 months later in 60 patients.


RESULTS
No patient died. Child-Pugh scores increased in all patients from a mean 5.96 to 6.28 (not significant) and 6.51 (P =. 05) after first and second TACEs, respectively. In patients with class A disease, scores increased from a mean 5.37 to 5.73 (P =.01) and 5.89 (P =.001) after first and second TACEs, respectively; in patients with class B disease, scores changed from a mean of 7.48 to 7.67 and 7.30 after first and second TACEs, respectively (not significant).


CONCLUSIONS
TACE does not induce significant long-term worsening of liver function in patients with class A or B cirrhosis.
Caturelli
E
E
Division of Gastroenterology, Ospedale "Casa Sollievo della Sofferenza" IRCC, Foggia, Italy.
Siena
D A
DA
Fusilli
S
S
Villani
M R
MR
Schiavone
G
G
Nardella
M
M
Balzano
S
S
Florio
F
F
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D002406:Catheterization, Peripheral; D016461:Chemoembolization, Therapeutic / Q000295:instrumentation / Q000379:methods; D003287:Contrast Media / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D005781:Gelatin Sponge, Absorbable / Q000008:administration & dosage; D006490:Hemostatics / Q000008:administration & dosage; D006499:Hepatic Artery; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage; D007479:Iopamidol / Q000008:administration & dosage; D008099:Liver / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000145:classification / Q000150:complications* / Q000503:physiopathology; D008113:Liver Neoplasms / Q000628:therapy*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012074:Remission Induction; D019233:Retreatment
D000903:Antibiotics, Antineoplastic; D003287:Contrast Media; D006490:Hemostatics; D007459:Iodized Oil; D004317:Doxorubicin; D007479:Iopamidol