Chemoembolization for primary liver cancer. |
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| Authors: | T Achenbach J K Seifert M B Pitton K Schunk T Junginger |
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| Affiliation: | 1. Klinik für Radiologie, Johannes Gutenberg, Universität Mainz, Mainz, Germany, Universität Mainz, Mainz, Germany;2. Johannes Gutenberg, Universität Mainz, Mainz, Germany, Klinik und Poliklinik für Allgemein und Abdominalchirurgie der Johannes Gutenberg, Universität Mainz, Mainz, Germany;1. Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA;2. Department of Neurosurgery, State University of New York at Buffalo, Buffalo, New York, USA;3. Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama, USA;1. Geneva University Hospital, Department of Imaging and Medical Information Sciences, Division of Radiology, Rue Gabrielle-Perret-Gentil 4, 1211 Genève 4, Switzerland;2. Geneva University Hospital, Department of Surgery, Division of Thoracic Surgery, Rue Gabrielle-Perret-Gentil 4, 1211 Genève 4, Switzerland;1. Aix-Marseille Université, IFSTTAR, Marseille, France;2. APHM, University Hospital Nord, Department of Vascular Surgery, Marseille, France;3. Aix-Marseille Université, CNRS, Ecole Centrale Marseille, Marseille, France;4. Aix-Marseille Université, Department of Public Health, Marseille, France;1. Department of Vascular Surgery, University of Arizona, Tucson, AZ;2. Baylor College of Medicine, Medical Center, Houston, Texas;1. Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, MN, United States;2. Division of Cardiovascular Disease, Mayo Clinic, Rochester, MN, United States |
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| Abstract: | AIMS: For most patients with primary liver cancer surgical treatment is not feasible and prognosis without treatment is poor. We aimed to assess the morbidity and efficacy of transarterial chemoembolization (TACE) with lipiodol and mitomycin C in these patients in a prospective case-control study. METHODS: From August 1996 to May 2000 22 patients with non-resectable hepatocellular carcinoma were treated with TACE. In case of radiological or tumour-marker response, treatment was repeated after 4--6 weeks, up to seven times per patient. RESULTS: Morbidity was 23% and usually minor, no patient died within 30 days of treatment. A decrease in size of the reference tumour or constant tumour-size in CT-scan were observed in 14 of 20 patients (70%) and of the 19 patients with elevated AFP-serum levels 12 (63%) had an AFP reduction following treatment. The median survival time was 14 months with a 1- and 2-year survival rate of 69% and 29%, respectively. Survival was not different in radiological or AFP responders vs non-responders. CONCLUSION: While TACE with lipiodol and mitomycin C for primary liver cancer is associated with considerable antitumoural efficacy, as demonstrated by tumour marker and radiological response, an effect on patient survival is not evident. New treatment options with an impact on survival are needed for these patients. |
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