Pre-operative chemoembolization at hepatocellular carcinoma in cirrhotic patients

V. Di Carlo, G. Ferrari, R. Castoldi, P. De Nardi, C. Bergamo, G. Taccagni, M. Salvioni, E. Angeli, M. Venturini, A. Del Maschio

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

BACKGROUND/AIMS: The aim of the study was to evaluate clinical and pathological effects of transcatheter arterial chemoembolization (TACE) before surgical resection for hepatocellular carcinoma (HCC) in cirrhosis (55 patients); results were compared with a group of 45 patients undergoing surgical resection without TACE. METHODOLOGY: From March 1989 to December 1997, 55 cirrhotic patients, affected by surgically resectable HCC not larger than 5 cm with unifocal or bifocal tumor lesions, underwent TACE pre-operatively. RESULTS: Massive necrosis was observed in 26%, necrosis > 50% in 38% of lesions. Neoplastic cells were found in 47% of cases within the capsule or in the pericapsular tissue. Satellite nodules showed a low rate of necrosis. Mortality and morbidity in the pre-operative TACE group were 1,8% and 29%, respectively, and 4,4% and 33%, respectively, in the control group. One-, 3- and 5-year patient survival rates were 87%, 70% and 39%, respectively, versus 79%, 38% and 19%, respectively (p <0.02), in the control group. Disease-free survival was 40% and 28% at 3 years and 5 years with pre-operative TACE versus 20% and 11% (p <0.05). CONCLUSIONS: Pre-operative TACE can be performed with low morbidity. TACE can necrotize the main lesion and temporarily arrest portal diffusion of neoplastic cells by acting on microvascular infiltration. No evident effect on satellites and pericapsular neoplastic foci was observed. The long-term patients and disease-free survival rates were improved upon.

Original languageEnglish
Pages (from-to)1950-1954
Number of pages5
JournalHepato-Gastroenterology
Volume45
Issue number24
Publication statusPublished - 1998

Fingerprint

Hepatocellular Carcinoma
Necrosis
Disease-Free Survival
Survival Rate
Morbidity
Control Groups
Capsules
Fibrosis
Mortality
Neoplasms

Keywords

  • Chemoembolization
  • Hepatocellular carcinoma
  • Liver resection

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Di Carlo, V., Ferrari, G., Castoldi, R., De Nardi, P., Bergamo, C., Taccagni, G., ... Del Maschio, A. (1998). Pre-operative chemoembolization at hepatocellular carcinoma in cirrhotic patients. Hepato-Gastroenterology, 45(24), 1950-1954.

Pre-operative chemoembolization at hepatocellular carcinoma in cirrhotic patients. / Di Carlo, V.; Ferrari, G.; Castoldi, R.; De Nardi, P.; Bergamo, C.; Taccagni, G.; Salvioni, M.; Angeli, E.; Venturini, M.; Del Maschio, A.

In: Hepato-Gastroenterology, Vol. 45, No. 24, 1998, p. 1950-1954.

Research output: Contribution to journalArticle

Di Carlo, V, Ferrari, G, Castoldi, R, De Nardi, P, Bergamo, C, Taccagni, G, Salvioni, M, Angeli, E, Venturini, M & Del Maschio, A 1998, 'Pre-operative chemoembolization at hepatocellular carcinoma in cirrhotic patients', Hepato-Gastroenterology, vol. 45, no. 24, pp. 1950-1954.
Di Carlo V, Ferrari G, Castoldi R, De Nardi P, Bergamo C, Taccagni G et al. Pre-operative chemoembolization at hepatocellular carcinoma in cirrhotic patients. Hepato-Gastroenterology. 1998;45(24):1950-1954.
Di Carlo, V. ; Ferrari, G. ; Castoldi, R. ; De Nardi, P. ; Bergamo, C. ; Taccagni, G. ; Salvioni, M. ; Angeli, E. ; Venturini, M. ; Del Maschio, A. / Pre-operative chemoembolization at hepatocellular carcinoma in cirrhotic patients. In: Hepato-Gastroenterology. 1998 ; Vol. 45, No. 24. pp. 1950-1954.
@article{ea61ee3ce15d4708b930eda3be5eaf33,
title = "Pre-operative chemoembolization at hepatocellular carcinoma in cirrhotic patients",
abstract = "BACKGROUND/AIMS: The aim of the study was to evaluate clinical and pathological effects of transcatheter arterial chemoembolization (TACE) before surgical resection for hepatocellular carcinoma (HCC) in cirrhosis (55 patients); results were compared with a group of 45 patients undergoing surgical resection without TACE. METHODOLOGY: From March 1989 to December 1997, 55 cirrhotic patients, affected by surgically resectable HCC not larger than 5 cm with unifocal or bifocal tumor lesions, underwent TACE pre-operatively. RESULTS: Massive necrosis was observed in 26{\%}, necrosis > 50{\%} in 38{\%} of lesions. Neoplastic cells were found in 47{\%} of cases within the capsule or in the pericapsular tissue. Satellite nodules showed a low rate of necrosis. Mortality and morbidity in the pre-operative TACE group were 1,8{\%} and 29{\%}, respectively, and 4,4{\%} and 33{\%}, respectively, in the control group. One-, 3- and 5-year patient survival rates were 87{\%}, 70{\%} and 39{\%}, respectively, versus 79{\%}, 38{\%} and 19{\%}, respectively (p <0.02), in the control group. Disease-free survival was 40{\%} and 28{\%} at 3 years and 5 years with pre-operative TACE versus 20{\%} and 11{\%} (p <0.05). CONCLUSIONS: Pre-operative TACE can be performed with low morbidity. TACE can necrotize the main lesion and temporarily arrest portal diffusion of neoplastic cells by acting on microvascular infiltration. No evident effect on satellites and pericapsular neoplastic foci was observed. The long-term patients and disease-free survival rates were improved upon.",
keywords = "Chemoembolization, Hepatocellular carcinoma, Liver resection",
author = "{Di Carlo}, V. and G. Ferrari and R. Castoldi and {De Nardi}, P. and C. Bergamo and G. Taccagni and M. Salvioni and E. Angeli and M. Venturini and {Del Maschio}, A.",
year = "1998",
language = "English",
volume = "45",
pages = "1950--1954",
journal = "Acta hepato-splenologica",
issn = "0172-6390",
publisher = "H.G.E. Update Medical Publishing Ltd.",
number = "24",

}

TY - JOUR

T1 - Pre-operative chemoembolization at hepatocellular carcinoma in cirrhotic patients

AU - Di Carlo, V.

AU - Ferrari, G.

AU - Castoldi, R.

AU - De Nardi, P.

AU - Bergamo, C.

AU - Taccagni, G.

AU - Salvioni, M.

AU - Angeli, E.

AU - Venturini, M.

AU - Del Maschio, A.

PY - 1998

Y1 - 1998

N2 - BACKGROUND/AIMS: The aim of the study was to evaluate clinical and pathological effects of transcatheter arterial chemoembolization (TACE) before surgical resection for hepatocellular carcinoma (HCC) in cirrhosis (55 patients); results were compared with a group of 45 patients undergoing surgical resection without TACE. METHODOLOGY: From March 1989 to December 1997, 55 cirrhotic patients, affected by surgically resectable HCC not larger than 5 cm with unifocal or bifocal tumor lesions, underwent TACE pre-operatively. RESULTS: Massive necrosis was observed in 26%, necrosis > 50% in 38% of lesions. Neoplastic cells were found in 47% of cases within the capsule or in the pericapsular tissue. Satellite nodules showed a low rate of necrosis. Mortality and morbidity in the pre-operative TACE group were 1,8% and 29%, respectively, and 4,4% and 33%, respectively, in the control group. One-, 3- and 5-year patient survival rates were 87%, 70% and 39%, respectively, versus 79%, 38% and 19%, respectively (p <0.02), in the control group. Disease-free survival was 40% and 28% at 3 years and 5 years with pre-operative TACE versus 20% and 11% (p <0.05). CONCLUSIONS: Pre-operative TACE can be performed with low morbidity. TACE can necrotize the main lesion and temporarily arrest portal diffusion of neoplastic cells by acting on microvascular infiltration. No evident effect on satellites and pericapsular neoplastic foci was observed. The long-term patients and disease-free survival rates were improved upon.

AB - BACKGROUND/AIMS: The aim of the study was to evaluate clinical and pathological effects of transcatheter arterial chemoembolization (TACE) before surgical resection for hepatocellular carcinoma (HCC) in cirrhosis (55 patients); results were compared with a group of 45 patients undergoing surgical resection without TACE. METHODOLOGY: From March 1989 to December 1997, 55 cirrhotic patients, affected by surgically resectable HCC not larger than 5 cm with unifocal or bifocal tumor lesions, underwent TACE pre-operatively. RESULTS: Massive necrosis was observed in 26%, necrosis > 50% in 38% of lesions. Neoplastic cells were found in 47% of cases within the capsule or in the pericapsular tissue. Satellite nodules showed a low rate of necrosis. Mortality and morbidity in the pre-operative TACE group were 1,8% and 29%, respectively, and 4,4% and 33%, respectively, in the control group. One-, 3- and 5-year patient survival rates were 87%, 70% and 39%, respectively, versus 79%, 38% and 19%, respectively (p <0.02), in the control group. Disease-free survival was 40% and 28% at 3 years and 5 years with pre-operative TACE versus 20% and 11% (p <0.05). CONCLUSIONS: Pre-operative TACE can be performed with low morbidity. TACE can necrotize the main lesion and temporarily arrest portal diffusion of neoplastic cells by acting on microvascular infiltration. No evident effect on satellites and pericapsular neoplastic foci was observed. The long-term patients and disease-free survival rates were improved upon.

KW - Chemoembolization

KW - Hepatocellular carcinoma

KW - Liver resection

UR - http://www.scopus.com/inward/record.url?scp=0032414878&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032414878&partnerID=8YFLogxK

M3 - Article

VL - 45

SP - 1950

EP - 1954

JO - Acta hepato-splenologica

JF - Acta hepato-splenologica

SN - 0172-6390

IS - 24

ER -