title: The efficacy of hepatic resection after neoadjuvant transarterial chemoembolization (TACE) and radiation therapy in hepatocellular carcinoma greater than 5 cm in size.
abstract: In cases of large hepatocellular carcinoma (HCC), neoadjuvant treatment such as transarterial chemoembolization (TACE) and radiation therapy can be performed. The aim of this study was to evaluate the outcome of these treatments prior to hepatic resection. Between January 1994 and May 2007, 16 patients with HCC greater than 5 cm in size were treated with TACE and radiation therapy prior to hepatic resection. The clinicopathologic factors were reviewed retrospectively. Of the 16 patients, there were 14 men and two women, and the median age was 52.5 yr. TACE was performed three times in average, and the median radiation dosage was 45 Gy. The median diameter of tumor on specimen was 9.0 cm. The degree of tumor necrosis was more than 90% in 14 patients. The median survival time was 13.3 months. Five patients had survived more than 2 yr and there were two patients who had survived more than 5 yr. Although the prognosis of large HCC treated with neoadjuvant therapy is not satisfactory, some showed long-term survival loger than 5 yr. Further research will be required to examine the survival and disease control effect in a prospective randomized study.
authors.affiliation: Department of Surgery, Severance Hospital, Liver Cancer Special Clinic Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sae Byeol
authors.initials: SB
authors.lastname: Choi
authors.forename: Kyung Sik
authors.initials: KS
authors.lastname: Kim
authors.forename: Young Nyun
authors.initials: YN
authors.lastname: Park
authors.forename: Jin Sub
authors.initials: JS
authors.lastname: Choi
authors.forename: Woo Jung
authors.initials: WJ
authors.lastname: Lee
authors.forename: Jinsil
authors.initials: J
authors.lastname: Seong
authors.forename: Kwang-Hyub
authors.initials: KH
authors.lastname: Han
authors.forename: Jong Tae
authors.initials: JT
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008099:Liver / Q000601:surgery*; D008113:Liver Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents; D004317:Doxorubicin