Chemoembolization for primary liver cancer.
OBJECTIVE
For most patients with primary liver cancer surgical treatment is not feasible and prognosis without treatment is poor. We aimed to assess the morbidity and efficacy of transarterial chemoembolization (TACE) with lipiodol and mitomycin C in these patients in a prospective case-control study.


METHODS
From August 1996 to May 2000 22 patients with non-resectable hepatocellular carcinoma were treated with TACE. In case of radiological or tumour-marker response, treatment was repeated after 4--6 weeks, up to seven times per patient.


RESULTS
Morbidity was 23% and usually minor, no patient died within 30 days of treatment. A decrease in size of the reference tumour or constant tumour-size in CT-scan were observed in 14 of 20 patients (70%) and of the 19 patients with elevated AFP-serum levels 12 (63%) had an AFP reduction following treatment. The median survival time was 14 months with a 1- and 2-year survival rate of 69% and 29%, respectively. Survival was not different in radiological or AFP responders vs non-responders.


CONCLUSIONS
While TACE with lipiodol and mitomycin C for primary liver cancer is associated with considerable antitumoural efficacy, as demonstrated by tumour marker and radiological response, an effect on patient survival is not evident. New treatment options with an impact on survival are needed for these patients.
Achenbach
T
T
Klinik für Radiologie, Johannes Gutenberg-Universität, Mainz, Germany.
Seifert
J K
JK
Pitton
M B
MB
Schunk
K
K
Junginger
T
T
D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000401:mortality / Q000628:therapy*; D016022:Case-Control Studies; D016461:Chemoembolization, Therapeutic; D005260:Female; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000097:blood / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D011446:Prospective Studies; D015996:Survival Rate; D000509:alpha-Fetoproteins / Q000032:analysis
D000903:Antibiotics, Antineoplastic; D000509:alpha-Fetoproteins; D016685:Mitomycin; D007459:Iodized Oil