Transcatheter arterial infusion chemotherapy prior to radiofrequency             thermal ablation for single hepatocellular carcinoma reduces the risk of intrahepatic             distant recurrence.
The aim of the present study was to elucidate the effectiveness of transcatheter arterial infusion chemotherapy (TAI) of the whole liver using an epirubicin-mitomycin-lipiodol emulsion, prior to radiofrequency thermal ablation (RFA), in preventing intrahepatic distant recurrence (IDR) from single hepatocellular carcinoma (HCC). Of the 269 consecutive patients who underwent RFA in our institute for single HCC, a total of 182 patients were analyzed in the present study. The primary endpoint was comparison of the post-RFA IDR-free survival rates in patients treated using TAI with an epirubicin-mitomycin-lipiodol emulsion via the proper hepatic artery (TAI-EML) prior to RFA, and patients that received lipiodol infusion-alone prior to RFA. The secondary endpoints were local tumor progression (LTP) and overall survival (OS). Lipiodol infusion-alone prior to RFA was performed in 88 patients and TAI-EML prior to RFA in 94 patients. The mean tumor size was 2.06 cm (range, 0.9-3.2 cm) in the TAI group and 1.97 cm (range, 0.9-3.3 cm) in the lipiodol-alone group, respectively. The cumulative IDR-free survival rates at 1, 2 and 3 years were 74.0, 50.8 and 34.9%, respectively, in the lipiodol-alone group, and 90.8, 74.8 and 70.0%, respectively, in the TAI group (P<0.001). In terms of the OS, there was a significant difference between these two groups (P=0.048), although there was no significant difference in terms of the LTP (P=0.145). We concluded that TAI-EML prior to RFA appears to be useful in reducing post-RFA IDR and may contribute to improved survival rates.
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka 543-0027, Japan. h-nishikawa@osaka-med.jrc.or.jp
Hiroki
H
Nishikawa
Yukio
Y
Osaki
Ryuichi
R
Kita
Toru
T
Kimura
Tadashi
T
Inuzuka
Haruhiko
H
Takeda
Jun
J
Nakajima
Fumihiro
F
Matsuda
Azusa
A
Sakamoto
Shinichiro
S
Henmi
Keiichi
K
Hatamaru
Sumio
S
Saito
Akihiro
A
Nasu
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D017115:Catheter Ablation; D017024:Chemotherapy, Adjuvant; D015251:Epirubicin / Q000627:therapeutic use; D004998:Ethiodized Oil / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008297:Male; D016685:Mitomycin / Q000627:therapeutic use; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D012189:Retrospective Studies; D016896:Treatment Outcome
D015251:Epirubicin; D016685:Mitomycin; D004998:Ethiodized Oil