Transcatheter arterial chemo-lipiodol infusion for unresectable hepatocellular carcinoma in 96 high-risk patients.

Abstract

AIM:

To evaluate the safety and efficacy of transcatheter arterial chemo-lipiodol infusion (TACL) in high-risk patients with unresectable hepatocellular carcinoma (HCC).

MATERIALS AND METHODS:

From January 2005 to April 2009, 96 patients underwent TACL. All patients had diffuse, infiltrative or multifocal tumours. Twenty-nine (30%) patients had an increased serum bilirubin level (>or=2mg/dl), and 75 patients (78%) had a low serum albumin level (<3.5mg/dl). The Child-Pugh (CP) score was 9 or more in 13 (14%) patients. Sixty-five patients (68%) had major portal vein occlusion. Sixteen patients (17%) had biliary dilatation.

RESULTS:

TACL was technically successful in all patients. After TACL, 18 (19%) of the 96 patients showed tumour response using computed tomography (CT) criteria. The 30 day mortality and morbidity rates were 1 and 2%, respectively. The median survival period was 8.6 months, and the overall 6 month, 1, 2, and 3 year survival rates were 59, 44, 26, and 15%, respectively. Portal vein occlusion (p<0.001) was the only significant risk factor associated with the length of the survival period after TACL, whereas the CP score (p=0.498), serum bilirubin level (p=0.153), serum albumin level (p=0.399), and biliary obstruction (p=0.636) had no significant effect.

CONCLUSIONS:

TACL can be performed safely in high risk HCC patients resulting in a median survival rate of 8.6 months in the present series.

• Authors: H-J Yoon, J H Kim, K-A Kim, I-S Lee, G-Y Ko, H-Y Song, D I Gwon
• Journal: Clinical radiology (Clin Radiol) Vol. 65 Issue 4 Pg. 271-7 (Apr 2010) ISSN: 1365-229X [Electronic] England
• PMID: 20338393 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Contrast Media
• Serum Albumin
• Iodized Oil
• Bilirubin

Topics

• Adult
• Aged
• Bilirubin (blood)
• Carcinoma, Hepatocellular (mortality, therapy)
• Chemoembolization, Therapeutic (adverse effects, methods, mortality)
• Contrast Media (therapeutic use)
• Female
• Humans
• Infusions, Intra-Arterial
• Iodized Oil (therapeutic use)
• Liver Neoplasms (mortality, therapy)
• Male
• Middle Aged
• Risk Factors
• Serum Albumin (chemistry)
• Survival Rate
• Tomography, X-Ray Computed
• Treatment Outcome