Skip to main content
NCBI home page
Japanese Journal of Cancer Research : Gann logoLink to Japanese Journal of Cancer Research : Gann
. 1996 Feb;87(2):206–211. doi: 10.1111/j.1349-7006.1996.tb03160.x

A Prospective Randomized Trial of the Preventive Effect of Pre‐operative Transcatheter Arterial Embolization against Recurrence of Hepatocellular Carcinoma

Susumu Yamasaki 1,✉, Hiroshi Hasegawa 2, Hiroaki Kinoshita 3, Masato Furukawa 4, Shingi Imaoka 5, Ken Takasaki 6, Youichiro Kakumoto 7, Hideki Saitsu 8, Ryusaku Yamada 9, Yukio Oosaki 10, Shigeki Arii 11, Eizo Okamoto 12, Morito Monden 13, Munemasa Ryu 14, Shouichi Kusano 15, Takashi Kanematsu 16, Kenji Ikeda 17, Masayuki Yamamoto 18, Takeo Saoshiro 19, Toshiharu Tsuzuki 20
PMCID: PMC5921067  PMID: 8609071

Abstract

To clarify whether pre‐operalive transcatheter arterial embolization (TAE) improves survival after hepatectomy, a prospective randomized comparative study was done. Of a total of 115 registered patients having solitary hepatocellular carcinoma (HCC) 2 to 5 cm in diameter, 18 (15.7%) were excluded after randomization. As a result, 97 patients were chosen as subjects and divided into two groups: hepatectomy with (group A: n = 50) and without (group B: n=47) pre‐operative TAE. The period of observation of the patients who survived the surgery was between 4.0 and 6.6 years. The randomization appeared to have provided well‐balanced groups of patients and the clinico‐pathological characteristics of the two groups were quite similar. The necrotic part of the cancerous lesions, as confirmed by operative specimens, amounted to 74.8 ±33.4% (mean±SD) in group A and 6.8 ±7.2% in group B (P<0.01). However, the cancer‐free survival rates after hepatectomy in both groups showed little difference (39.1±7.0 (%±SE) and 31.1±0.1, respectively). We speculate that TAE is not effective against such HCC accessory lesions as minute intrahepatic metastasis and tumor thrombus and that pre‐operative TAE does not improve post‐operative survival.

Keywords: Pre‐operative TAE, Hepatocellular carcinoma, Recurrence, Survival rate

Full Text

The Full Text of this article is available as a PDF (347.8 KB).

REFERENCES

  • 1).Yamada , R. , Nakatsuka , H. , Nakamura , K. , Sato , M. , Itami , M. , Kobayashi , N. , Minakuchi , K. , Onoyama , Y. , Kanno , T. , Monna , T. and Yamamoto , S.Hepatic artery embolization in 32 patients with unresectable hepatoma . Osaka City Med. J. 26 , 81 – 96 ( 1980. ). [PubMed] [Google Scholar]
  • 2).Goldstein , H. M. , Medellin , H. , Ben‐Menachem , Y. and Wallace , S.Transcatheter arterial embolization in the management of bleeding in the cancer patient . Radiology 115 , 603 – 608 ( 1975. ). [DOI] [PubMed] [Google Scholar]
  • 3).Wheeler , P. G. , Melia , W. , Dubbins , P. , Jones , B. , Nunnerley , H. , Johnson , P. and Williams , R.Nonoperative arterial embolisation in primary liver tumours . Br. Med. J. 2 , 242 – 244 ( 1979. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 4).Yamada , R. , Nakatsuka , H. , Nakamura , K. , Sato , M. , Tamaoka , K. , Takemoto , K. , Minakuchi , K. , Yamaguchi , S. , Tamaki , M. , Monna , T. and Yamamoto , S.Transcatheter arterial embolization therapy in nonresectable hepatoma, experience in 15 cases . Acta Hepatol. Jpn. 20 , 595 – 603 ( 1979. ) ( in Japanese ). [Google Scholar]
  • 5).Okuda , K. , Ohtsuki , T. , Obata , H. , Tomomatsu , M. , Okazaki , N. , Hasegawa , H. , Nakajima , Y. and Ohnishi , K.Natural history of hepatocellular carcinoma and prognosis in relation to treatment . Cancer 56 , 918 – 928 ( 1985. ). [DOI] [PubMed] [Google Scholar]
  • 6).Yamada , R. , Sato , M. , Kawabata , M. , Nakatsuka , H. , Nakamura , K. and Takashima , S.Hepatic arterial embolization in 120 patients with unresectable hepatoma . Radiology 148 , 397 – 401 ( 1983. ). [DOI] [PubMed] [Google Scholar]
  • 7).Yamasaki , S. , Hasegawa , H. and Makuuchi , M.Surgical treatment for hepatocellular carcinoma . Jpn. J. Cancer Clin. 32 , 1267 – 1272 ( 1986. ) ( in Japanese ). [PubMed] [Google Scholar]
  • 8).Nagasue , N. , Galizia , G. , Kohno , H. , Chang , Y. C. , Hayashi , T. , Yamanoi , A. , Nakamura , T. and Yukaya , H.Adverse effects of preoperative hepatic artery chemo‐embolization for resectable hepatocellular carcinoma: a retrospective comparison of 138 liver resections . Surgery 106 , 81 – 86 ( 1989. ). [PubMed] [Google Scholar]
  • 9).Imaoka , S. , Sasaki , Y. , Shibata , T. , Fujita , M. , Kasugai , H. , Kojima , J. , Ishiguro , S. , Ohigashi , H. , Ishikawa , O. , Fukuda , I. , Furukawa , H. , Koyama , H. and Iwanaga , T.A pre‐operative chemoembolization therapy using lipiodol, cisplatin and gelatin sponge for hepatocellular carcinoma . Cancer Chemother. , 23 ( Suppl. ), 126 – 128 ( 1989. ). [DOI] [PubMed] [Google Scholar]
  • 10).Adachi , E. , Matsumata , T. , Nishizaki , T. , Hashimoto , H. , Tsuneyoshi , M. and Sugimachi , K.Effects of preoperative transcatheter hepatic chemo‐embolization for hepatocellular carcinoma, the relationship between post‐operative course and tumor necrosis . Cancer 72 , 3593 – 3598 ( 1993. ). [DOI] [PubMed] [Google Scholar]
  • 11).Lin , D. Y. , Liaw , Y. F. , Lee , T. Y. and Lai , C. M.Hepatic arterial embolization in patients with unresectable hepatocellular carcinoma, a randomized controlled trial . Gastro-enterology 94 , 453 – 456 ( 1988. ). [DOI] [PubMed] [Google Scholar]
  • 12).Pelletier , G. , Roche , A. , Ink , O. , Anciaux , M. L. , Derhy , S. , Rougier , P. , Lenoir , C. , Attali , P. and Etienne , J. P.A randomized trial of hepatic arterial chemoembolization in patients with unresectable hepatocellular carcinoma . J. Hepatol. 11 , 181 – 184 ( 1990. ). [DOI] [PubMed] [Google Scholar]
  • 13).Okuda , K. , Obata , H. , Nakajima , Y. , Ohtsuki , T. , Okazaki , N. and Ohnishi , K.Prognosis of primary hepatocellular carcinoma . Hepatology 4 , 3S – 6S ( 1984. ). [DOI] [PubMed] [Google Scholar]
  • 14).Yamashita , Y. , Takahashi , M. , Koga , Y. , Saito , R. , Nanakawa , S. , Hatanaka , Y. , Sato , N. , Nakashima , K. , Urata , J. , Yoshizumi , K. , Ito , K. , Sumi , S. and Kan , M.Prognostic factors in the treatment of hepatocellular carcinoma with transcatheter arterial embolization and arterial infusion . Cancer 67 , 385 – 391 ( 1991. ). [DOI] [PubMed] [Google Scholar]
  • 15.The 15th Study Group by a Grant‐in‐Aid for Cancer Research from the Ministry of Health and Welfare of Japan. Multidisciplinary treatment for liver cancer: hepatic resection with preoperative transcatheter arterial embolization (The first report) . Liver-Gall Bladder-Pancreas 5 , 1195 – 1200 ( 1982. ) ( in Japanese ). [Google Scholar]
  • 16.The 15th Study Group by a Grant‐in‐Aid for Cancer Research from the Ministry of Health and Welfare of Japan. Multidisciplinary treatment for liver cancer: hepatic resection with preoperative transcatheter arterial embolization (The second report) . Intern. Med. 52 , 555 – 559 ( 1983. ) ( in Japanese ). [Google Scholar]
  • 17).Yamasaki , S. , Hasegawa , H. and Makuuchi , M.Clinico‐pathological observation of the minute liver cancer and the new method of hepatectomy: analysis of 27 resected cases . Acta Hepatol. Jpn. 22 , 1714 – 1724 ( 1981. ) ( in Japanese ). [Google Scholar]
  • 18).Sakurai , M. , Okamura , J. and Kuroda , C.Transcatheter chemoembolization effective for treating hepatocellular carcinoma, a histopathologic study . Cancer 54 , 387 – 392 ( 1984. ). [DOI] [PubMed] [Google Scholar]
  • 19).Hwang , T. L. , Chen , M. F. , Lee , T. Y. , Chen , T. J. , Lin , D. Y. and Liaw , Y. F.Resection of hepatocellular carcinoma after transcatheter arterial embolization . Arch. Surg. 122 , 756 – 759 ( 1987. ). [DOI] [PubMed] [Google Scholar]

Articles from Japanese Journal of Cancer Research : Gann are provided here courtesy of Wiley

RESOURCES