Long-term prognosis after arterio-portal embolization for hepatocellular carcinoma.
OBJECTIVE
Resection is the treatment of choice for hepatocellular carcinoma. However, relatively few patients with hepatocellular carcinoma are surgical candidates. The efficacy of a radiologic hepatectomy, achieved by combined embolization of the arterial and portal tumor blood supply, was determined and compared to surgical hepatectomy in a retrospective analysis.


METHODS
The records of 32 patients treated for hepatocellular carcinoma between 1989 and 1992 were reviewed. The outcome in 15 patients treated with combined selective segmental portal vein embolization and hepatic artery embolization without hepatectomy (Embolization group) was compared with the outcome in 17 patients who under went curative hepatic resection (Resection group). The recurrence-free and cumulative survival rates were compared in the two groups.


RESULTS
Except for a greater number of men in the Resection Group (p=0.03), the demographics and clinical characteristics of the two groups were similar at baseline. There was no patient who died within 30 days of treatment. The recurrence-free survival rates after embolization and resection were 20.8 and 23.4% at 5 years, respectively. The corresponding cumulative survival rates were 23.2 and 51.3%.


CONCLUSIONS
Combined embolization without hepatectomy may be a viable alternative to curative hepatectomy for selected patients with hepatocellular carcinoma.
Mamada
Yasuhiro
Y
The First Department of Surgery, Nippon Medical School, Tokyo, Japan. mamachan@nms.ac.jp
Tajiri
Takashi
T
Akimaru
Koho
K
Yoshida
Hiroshi
H
Taniai
Nobuhiko
N
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery / Q000628:therapy*; D004621:Embolization, Therapeutic; D005260:Female; D006498:Hepatectomy; D006499:Hepatic Artery; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D011379:Prognosis; D012189:Retrospective Studies