title: Transarterial infusion chemotherapy with epirubicin in water-in-oil-in-water emulsion for recurrent hepatocellular carcinoma in the residual liver after hepatectomy.
abstract: OBJECTIVE
  To evaluate the midterm results of transarterial infusion (TAI) with water-in-oil-in-water (W/O/W) emulsion containing an anticancer agent for patients with recurrent hepatocellular carcinoma (HCC) after surgical resection.
  
  
  METHODS
  We retrospectively analyzed the results of TAI of W/O/W emulsion containing epirubicin for 18 consecutive patients with recurrent HCC after surgical resection. Fourteen patients were males and four were females; their ages ranged from 51 to 86 years (mean 69.8 years). TAI was repeated every 1-6 months based on the response of the tumor. A total of 41 TAI procedures were performed for 18 patients. Angiographically, recurrent HCC appeared a single nodule in nine patients and was multinodular in other nine patients. TAI was performed selectively in 27 procedures and non-selectively in 14 procedures. Maximum response within 3 months was rated as follows: a complete response (CR, complete disappearance of tumor and no evidence of new lesions); partial response (PR, a reduction of <50% in total volume of all tumors calculated from the two longest perpendicular diameters without a new lesion); no response (NC, a reduction of <50% in total volume or an increase of <25% without a new lesion); or progression of disease (PD, an increase of >25% in total volume or evidence of new lesions). Survival time was defined as the time from the date of first TAI to the date of death or last follow-up (median follow-up time: 17 months) and the survival curve was estimated using the Kaplan-Meier method.
  
  
  RESULTS
  The CR rate was 33% and the effective response rate (CR rate+PR rate) was 78%. Survival from the time of initial TAI was 94% at 1 year, 76% at 2 years, and 76% at 3 years.
  
  
  CONCLUSIONS
  TAI of W/O/W emulsion may be an effective treatment for patients with recurrent HCC after surgical resection.
authors.affiliation: Department of Radiology, Miyakonojo Medical Association Hospital, 5822-3 Oiwadacho, Miyakonojo 885-0062, Japan. iku-i@fk.enjoy.ne.jp
authors.forename: Ichiro
authors.initials: I
authors.lastname: Ikushima
authors.forename: Shushi
authors.initials: S
authors.lastname: Higashi
authors.forename: Koji
authors.initials: K
authors.lastname: Seguchi
authors.forename: Akihiko
authors.initials: A
authors.lastname: Ishii
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Ota
authors.forename: Masayasu
authors.initials: M
authors.lastname: Shima
authors.forename: Mikio
authors.initials: M
authors.lastname: Kanemaru
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Hidaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D004337:Drug Carriers / Q000737:chemistry; D004655:Emulsions / Q000737:chemistry; D015251:Epirubicin / Q000008:administration & dosage* / Q000737:chemistry; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000517:prevention & control; D009821:Oils / Q000737:chemistry; D011859:Radiography; D016896:Treatment Outcome; D014867:Water / Q000737:chemistry
chemical_list: D000903:Antibiotics, Antineoplastic; D004337:Drug Carriers; D004655:Emulsions; D009821:Oils; D014867:Water; D015251:Epirubicin