RM-019 Transcatheter arterial chemoembolisation for hepatocellular carcinoma in cirrhosis: feasibility of hepatic resection

Abstract

ABSTRACT Background Hepatocelullar carcinoma (HCC) is the fifth most common cancer in the world. It mostly occurs in patients with cirrhosis. The aim of investigation is to evaluate the efficiency of transcatheter arterial chemoembolization (TACE) for unresectable HCC in cirrhosis and use of it in preoperative stage. Materials and methods We evaluated data from 49 patients who had a confirmed diagnosis of HCC on cirrhosis. Median age of the patients was 56 years. Male – 35 (71.4%, female – 14 (28.6%). In 33 (67.3%) cases tumor located in right lobe and in 16 (32.7%) cases located in left lobe. In 7 (14.3%) cases tumor size consisted 8-12 cm, in 32 (65.3%) 12-15 cm and in 10 (20.4%) cases more than 15 cm. The underlying cirrhosis was staged as Child-Pugh A in 14(28.6%) cases and Child-Pugh B in 35 (71.4%). We selectively catheterized the tumour via arteria femoralis and used Doxorubicin with Lipiodol as embolic material. Results In follow up, we carried out laboratory studies and CT. Three weeks after TACE there are dominated tumours with the sizes 8-12 cm (in 16 (32.7 patients)) due to reduction of tumour sizes. Reduction of tumour sizes averaged 26.7 ± 0.4 mm. There is noted physiological increase of opposite part of live from 1 up to 3 cm, averagely 23 ± 0.32 mm in 46 (93.9%) patients. Alpha-fetoprotein normalized in 37 patients, which was high before manipulation. After TACE patients were restaged and Child-Pugh class A noted in 25 (51%), class B noted in 24 (49%) patients. There is not noted full clinical effect, partial effect noted in 21 (42.9%) patients, stable process in 13 (26.5%) patients. Twenty one of the 49 patients (49%) selected for surgical treatment according objective changes, reduction of tumour sizes and improvement of opposite part of liver after TACE. Conclusions TACE is safe method, it provides reduction of tumour sizes, intensifies influx of arterial blood to the opposite part of liver which improves liver function and conducts to hypertrophy of remaining part of liver. In 49% of unresectable HCC patients TACE conducts to curative hepatic resection. Disclosure All authors have declared no conflicts of interest.