title: Prevention of intrahepatic distant recurrence by transcatheter arterial infusion chemotherapy with platinum agents for stage I/II hepatocellular carcinoma.
abstract: BACKGROUND
  The effectiveness of additional chemotherapy in preventing intrahepatic distant tumor recurrence of hepatocellular carcinoma (HCC) has not been fully established. The authors compared the efficacy of 2 platinum-based chemotherapeutic agents in combination with radical local treatment for preventing intrahepatic distant recurrence (IDR).
  
  
  METHODS
  Seventy-eight patients with stage I/II HCC aged 45 to 85 years underwent transcatheter arterial chemoembolization and/or radiofrequency ablation after they received hepatic arterial infusion (HAI) of platinum compounds. The HAI consisted of cis-diammine(1,1-cyclobutanedicarboxylato)platinum(II) (carboplatin) in 25 patients and cis-diamminedichloroplatinum (II) (cisplatin) in 53 patients. Multivariate analysis was used to identify independent factors that were associated with IDR.
  
  
  RESULTS
  Cumulative IDR rates at 1 year, 2 years, and 3 years were 21.7%, 52.2% and 75.7%, respectively, in the carboplatin group and 8.1%, 22.7%, and 36.9%, respectively, in the cisplatin group. The cisplatin group had a significantly lower IDR rate compared with the carboplatin group. The selection of a platinum agent was 1 of the independent factors for IDR in a multivariate Cox proportional hazards model.
  
  
  CONCLUSIONS
  HAI chemotherapy with cisplatin before radical local treatment was effective in patients with HCC. The authors concluded that radical local treatment with concurrent HAI using cisplatin may contribute to a longer progression-free period, which could be predicted with intrahepatic imaging in patients with stage I/II HCC.
authors.affiliation: Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, Niigata, Japan. toruishi@ngt.saiseikai.or.jp
authors.forename: Toru
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Kazuo
authors.initials: K
authors.lastname: Higuchi
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kubota
authors.forename: Keiichi
authors.initials: K
authors.lastname: Seki
authors.forename: Terasu
authors.initials: T
authors.lastname: Honma
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Yoshida
authors.forename: Tomoteru
authors.initials: T
authors.lastname: Kamimura
mesh_terms: D000368:Aged; D016190:Carboplatin / Q000008:administration & dosage* / Q000009:adverse effects; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000379:methods*; D008113:Liver Neoplasms / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000517:prevention & control*; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control
chemical_list: D016190:Carboplatin; D002945:Cisplatin