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 language | English |
|---|---|
| Pages (from-to) | 1950-1954 |
| Number of pages | 5 |
| Journal | Hepato-Gastroenterology |
| Volume | 45 |
| Issue number | 24 |
| Publication status | Published - 1998 |
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Keywords
- Chemoembolization
- Hepatocellular carcinoma
- Liver resection
ASJC Scopus subject areas
- Gastroenterology
Cite this
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 journal › Article
}
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
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M3 - Article
VL - 45
SP - 1950
EP - 1954
JO - Acta hepato-splenologica
JF - Acta hepato-splenologica
SN - 0172-6390
IS - 24
ER -