title: Re-evaluation of lipiodolized transarterial chemoembolization therapy for intrahepatic recurrence of hepatocellular carcinoma after curative liver resection.
abstract: OBJECTIVE
  While lipiodolized transarterial chemoembolization (lip-TACE) is effective for treating unresectable hepatocellular carcinoma (HCC), its effect for treating recurrent HCC after curative liver resection needs to be clarified.
  
  
  METHODS
  Of 163 patients who had undergone curative liver resection between 1992 and December 2003, 65 patients (39.8%) had recurrent HCC in the liver without extrahepatic recurrence and were indicated for lip-TACE. The overall survival rate after lip-TACE was calculated, and its correlation with factors such as the histology of the primary HCC and background noncancerous tissue were analyzed.
  
  
  RESULTS
  The overall survival rates after lip-TACE after the detection of the first recurrent HCC were 82.6%, 44.5%, and 24.8% at 1, 3, and 5 years, respectively. The factors affecting patient survival after lip-TACE were microscopic portal venous involvement of HCC at liver resection, grade of inflammation in the noncancerous liver parenchyma, and recurrence within 1 year after the initial liver resection. Multivariate analysis showed that the period between the resection and first recurrence had the highest hazard ratio.
  
  
  CONCLUSIONS
  Lip-TACE is a reasonable procedure for treating recurrent HCC in selected patients who are not eligible for hepatic re-resection. When HCC recurred within 1 year from the primary liver resection, the effect of lip-TACE on patient survival was limited.
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Eguchi
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Koji
authors.initials: K
authors.lastname: Hamasaki
authors.forename: Mitsuhisa
authors.initials: M
authors.lastname: Takatsuki
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hidaka
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Tajima
authors.forename: Ichiro
authors.initials: I
authors.lastname: Sakamoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanematsu
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007459:Iodized Oil / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000628:therapy; D016016:Proportional Hazards Models; D015996:Survival Rate
chemical_list: D007459:Iodized Oil