Preoperative treatment of hepatocellular carcinoma with intra-arterial injection of 131I-labelled lipiodol.
BACKGROUND
Recurrence is common after surgery for hepatocellular carcinoma (HCC).


METHODS
The efficacy of, and tolerance to, preoperative intra-arterial injection of (131)I-labelled lipiodol was examined in 34 patients with HCC, including 29 with cirrhosis. Twenty-five patients had a single hepatic tumour and the mean(s.d.) tumour size was 5.2(3.7) (range 2-15) cm. The patients received between one and three injections of (131)I-labelled lipiodol (60 mCi per injection) before surgery. Operations included 14 liver transplants, 13 minor hepatectomies, six major hepatectomies and one exploratory laparotomy.


RESULTS
There was one complication after lipiodol injection due to acute ischaemia of the small bowel. Three of 34 patients died within 28 days, two after transplantation and one after resection. An objective tumour response (decrease in tumour size) was observed in 19 of 34 patients, and a complete histological response in eight of 34. There was an objective tumour response or major histological necrosis of lesions in 25 of 34 patients. The 5-year survival rate was 48.4(8.0) per cent, 69.0 per cent after transplantation and 36.0 per cent in patients who underwent resection.


CONCLUSIONS
This preoperative method appeared to be well tolerated, and provided promising results in terms of macroscopic and microscopic tumour responses.
Département d'Oncologie Médicale, Centre E Marquis, Rennes Cedex, France. raoul@rennes.fnclcc.fr
J-L
JL
Raoul
M
M
Messner
E
E
Boucher
J-F
JF
Bretagne
J-P
JP
Campion
K
K
Boudjema
D006528:Carcinoma, Hepatocellular / Q000532:radiotherapy* / Q000601:surgery; D003287:Contrast Media; D005260:Female; D006498:Hepatectomy / Q000379:methods / Q000401:mortality; D006801:Humans; D007269:Injections, Intra-Arterial; D007457:Iodine Radioisotopes / Q000008:administration & dosage*; D007459:Iodized Oil / Q000008:administration & dosage*; D008113:Liver Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods; D016019:Survival Analysis; D016896:Treatment Outcome
D003287:Contrast Media; D007457:Iodine Radioisotopes; D007459:Iodized Oil