Transarterial embolization with microspheres in the treatment of monofocal HCC.
BACKGROUND
Transarterial embolization using one permanent embolic agent alone enhances tumour ischaemia and spares patients with hepatocellular carcinoma form toxic chemotherapeutic drugs.


OBJECTIVE
We assessed feasibility, tolerability and efficacy of transarterial embolization with microspheres in patients with a single node hepatocellular carcinoma.


METHODS
Eighteen consecutive patients with compensated cirrhosis, hypervascularized single hepatocellular carcinoma, in whom liver transplantation was indicated (no.=3), or excluded from radical therapies (no.=15), received selective transarterial embolization with microspheres. Treatment was repeated every other month until complete devascularitazion was demonstrated by computed tomography, for a maximum of 3 cycles.


RESULTS
Fifty transarterial embolization courses (mean: 2.8 courses, range 1-6) were administered, corresponding to a 100% applicability rates. Initial complete response was achieved in 16 (89%) patients and confirmed by histology in 2 transplanted patients. During 21-month follow-up (range 8-36), hepatocellular carcinoma recurred in 10 (62%) patients who achieved initial complete response, and de novo tumour nodes developed in 10 (56%). No patient required analgesics and none had liver function deteriorated following transarterial embolization.


CONCLUSIONS
Transarterial embolization is a well-tolerated treatment for patients with early or intermediate hepatocellular carcinoma who are not suitable for radical treatment or await liver transplantation, but it allows to achieve a sustained complete response in a minority of patients.
Nicolini
A
A
Division of Radiology, IRCCS Maggiore Hospital, Fondazione Policlinico, Mangiagalli e Regina Elena, and Centro A. M. & A. Migliavacca, University of Milan, Milan, Italy.
Fasani
P
P
Manini
M A
MA
Martinetti
L
L
Forzenigo
L V
LV
Iavarone
M
M
Crespi
S
S
Rossi
G
G
Biondetti
P
P
Colombo
M
M
Sangiovanni
A
A
D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007269:Injections, Intra-Arterial / Q000295:instrumentation / Q000379:methods; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D016896:Treatment Outcome