Skip to main content
SpringerLink
Log in

A Prospective Randomized Controlled Trial of Preoperative Whole-Liver Chemolipiodolization for Hepatocellular Carcinoma

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Background

We previously reported that preoperative chemolipiodolization of the whole liver is effective for reducing the incidence of postoperative recurrence and prolonging survival in patients with resectable hepatocellular carcinoma (HCC). The present randomized controlled trial was performed to evaluate the influence of preoperative transcatheter arterial chemoembolization (TACE) on survival after the resection of HCC.

Methods

Operative results and long-term outcome were prospectively compared among 42 patients who received only selective TACE targeting the tumor (selective group), 39 patients who received TACE targeting the tumor plus chemolipiodolization of the whole liver (whole-liver group), and 43 patients without preoperative TACE or chemolipiodolization (control group).

Results

There were no serious side effects of TACE or chemolipiodolization and the operative outcomes did not differ among the three groups. Even though preoperative TACE induced complete tumor necrosis, there were no significant differences in the pattern of intrahepatic recurrence or the time until recurrence among the three groups. There were also no significant differences in disease-free survival or overall survival among the three groups, even among patients with larger tumor size.

Conclusion

These results indicate that preoperative selective TACE and whole-liver chemolipiodolization plus TACE do not reduce the incidence of postoperative recurrence or prolong survival in patients with resectable HCC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Bosch FX, Ribes J, Borràs J. Epidemiology of primary liver cancer. Semin Liver Dis. 1999;19:271–285.

    Article  PubMed  CAS  Google Scholar 

  2. Taylor-Robinson SD, Foster GR, Arora S, Hargreaves S, Thomas HC. Increase in primary liver cancer in the UK, 1979–94. Lancet. 1997;350:1142–1143.

    Article  PubMed  CAS  Google Scholar 

  3. El-Serag HB, Mason AC. Rising incidence of hepatocellular carcinoma in the United States. N Engl J Med. 1999;340:745–750.

    Article  PubMed  CAS  Google Scholar 

  4. Kotoh K, Sakai H, Sakamoto S, et al. The effect of percutaneous ethanol injection therapy on small solitary hepatocellular carcinoma is comparable to that of hepatectomy. Am J Gastroenterol. 1994;89:194–198.

    PubMed  CAS  Google Scholar 

  5. Seki T, Wakabayashi M, Nakagawa T, et al. Ultrasonically guided percutaneous microwave coagulation therapy for small hepatocellular carcinoma. Cancer. 1994;74:817–825.

    Article  PubMed  CAS  Google Scholar 

  6. Chen MS, Li JQ, Zheng Y, et al. A prospective randomized trial comparing percutaneous local ablative therapy and partial hepatectomy for small hepatocellular carcinoma. Ann Surg. 2006;243:321–328.

    Article  PubMed  Google Scholar 

  7. Tung-Ping Poon R, Fan ST, Wong J. Risk factors, prevention, and management of postoperative recurrence after resection of hepatocellular carcinoma. Ann Surg. 2000;232:10–24.

    Article  PubMed  CAS  Google Scholar 

  8. Nakamura H, Tanaka T, Hori S, et al. Transcatheter embolization of hepatocellular carcinoma: assessment of efficacy in cases of resection following embolization. Radiology. 1983;147:401–405.

    PubMed  CAS  Google Scholar 

  9. Sakurai M, Okamura J, Kuroda C. Transcatheter chemo-embolization effective for treating hepatocellular carcinoma. A histopathologic study. Cancer. 1984;54:387–392.

    Article  PubMed  CAS  Google Scholar 

  10. Harada T, Matsuo K, Inoue T, et al. Is preoperative hepatic arterial chemoembolization safe and effective for hepatocellular carcinoma? Ann Surg. 1996;224:4–9.

    Article  PubMed  CAS  Google Scholar 

  11. Lu CD, Peng SY, Jiang XC, Chiba Y, Tanigawa N. Preoperative transcatheter arterial chemoembolization and prognosis of patients with hepatocellular carcinomas: retrospective analysis of 120 cases. World J Surg. 1999;23:293–300.

    Article  PubMed  CAS  Google Scholar 

  12. Sugo H, Futagawa S, Beppu T, Fukasawa M, Kojima K. Role of preoperative transcatheter arterial chemoembolization for resectable hepatocellular carcinoma: relation between postoperative course and the pattern of tumor recurrence. World J Surg. 2003;27:1295–1299.

    Article  PubMed  Google Scholar 

  13. Majno PE, Adam R, Bismuth H, et al. Influence of preoperative transarterial lipiodol chemoembolization on resection and transplantation for hepatocellular carcinoma in patients with cirrhosis. Ann Surg. 1997;226:688–703.

    Article  PubMed  CAS  Google Scholar 

  14. Uchida M, Kohno H, Kubota H, et al. Role of preoperative transcatheter arterial oily chemoembolization for resectable hepatocellular carcinoma. World J Surg. 1996;20:326–331.

    Article  PubMed  CAS  Google Scholar 

  15. Yamasaki S, Hasegawa H, Kinoshita H, et al. A prospective randomized trial of the preventive effect of pre-operative transcatheter arterial embolization against recurrence of hepatocellular carcinoma. Jpn J Cancer Res. 1996;87:206–211.

    Article  PubMed  CAS  Google Scholar 

  16. Nagasue N, Kohno H, Tachibana M, Yamanoi A, Ohmori H, El-Assal ON. Prognostic factors after hepatic resection for hepatocellular carcinoma associated with child-turcotte class B and C cirrhosis. Ann Surg. 1999;229:84–90.

    Article  PubMed  CAS  Google Scholar 

  17. Wu CC, Ho YZ, Ho WL, Wu TC, Liu TJ, P’eng FK. Preoperative transcatheter arterial chemoembolization for resectable large hepatocellular carcinoma: a reappraisal. Br J Surg. 1995;82:122–126.

    Article  PubMed  CAS  Google Scholar 

  18. Zhou WP, Lai EC, Li AJ, et al. A prospective, randomized, controlled trial of preoperative transarterial chemoembolization for resectable large hepatocellular carcinoma. Ann Surg. 2009;249:195–202.

    Article  PubMed  Google Scholar 

  19. Kaibori M, Tanigawa N, Matsui Y, Kwon AH, Sawada S, Kamiyama Y. Preoperative chemolipiodolization of the whole liver for hepatocellular carcinoma. Anticancer Res. 2004;24:1929–1933.

    PubMed  CAS  Google Scholar 

  20. Oken MM, Creech RH, Tormey DC, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982;5:649–655.

    Article  PubMed  CAS  Google Scholar 

  21. Kwon AH, Ha-Kawa SK, Uetsuji S, Inoue T, Matsui Y, Kamiyama Y. Preoperative determination of the surgical procedure for hepatectomy using technetium-99m-galactosyl human serum albumin (99mTc-GSA) liver scintigraphy. Hepatology. 1997;25:426–429.

    Article  PubMed  CAS  Google Scholar 

  22. Strasberg SM, Belghiti J, Clavn P-A, et al. The Brisbane 2000 terminology of liver anatomy and resection. Terminology Committee of the International Hepato-Pancreato-Biliary Association. HPB. 2000;2:333–339.

    Google Scholar 

  23. Couinaud C, ed. Le Foie: Études Anatomiques et Chirurgicales. Paris: Masson; 1957.

    Google Scholar 

  24. Sobin LH, Wittekind C, eds. TNM Classification of Malignant Tumours. 5th ed. New York: Wiley; 1997.

    Google Scholar 

  25. Yamada R, Sato M, Kawabata M, Nakatsuka H, Nakamura K, Takashima S. Hepatic artery embolization in 120 patients with unresectable hepatoma. Radiology. 1983;148:397–401.

    PubMed  CAS  Google Scholar 

  26. Sato Y, Fujiwara K, Ogata I, et al. Transcatheter arterial embolization for hepatocellular carcinoma. Benefits and limitations for unresectable cases with liver cirrhosis evaluated by comparison with other conservative treatments. Cancer. 1985;55:2822–2825.

    Article  PubMed  CAS  Google Scholar 

  27. Llovet JM, Bruix J. Systematic review of randomized trials for unresectable hepatocellular carcinoma: chemoembolization improves survival. Hepatology. 2003;37:429–442.

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Surgery, Kansai Medical University, 2-3-1 Shinmachi, Hirakata, Osaka, 573-1191, Japan

    Masaki Kaibori & A-Hon Kwon

  2. Department of Radiology, Kansai Medical University, Hirakata, Osaka, 573-1191, Japan

    Noboru Tanigawa, Shuji Kariya & Satoshi Sawada

  3. Department of Gastroenterology and Hepatology, Kansai Medical University, Hirakata, Osaka, 573-1191, Japan

    Hiroki Ikeda, Yoshitsugu Nakahashi, Junko Hirohara, Chizu Koreeda, Toshihito Seki & Kazuichi Okazaki

Authors
  1. Masaki Kaibori
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Noboru Tanigawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shuji Kariya
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroki Ikeda
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yoshitsugu Nakahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Junko Hirohara
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Chizu Koreeda
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Toshihito Seki
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Satoshi Sawada
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Kazuichi Okazaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. A-Hon Kwon
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Masaki Kaibori.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kaibori, M., Tanigawa, N., Kariya, S. et al. A Prospective Randomized Controlled Trial of Preoperative Whole-Liver Chemolipiodolization for Hepatocellular Carcinoma. Dig Dis Sci 57, 1404–1412 (2012). https://doi.org/10.1007/s10620-012-2029-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-012-2029-3

Keywords

Search

Navigation