Transcatheter chemo-embolization effective for treating hepatocellular carcinoma. A histopathologic study

Abstract

A histopathologic study was done on livers from 14 patients who underwent surgery for hepatocellular carcinoma and who had been pretreated by a combination of intra‐arterial embolization of Gelfoam (Upjohn) plus intra‐arterial chemotherapy. This technique was effective as the excess vascularity of the tumor and the tumor bulk were reduced and resection was readily facilitated. For solitary tumors of less than 4 cm in diameter, this approach was particularly effective. As this combined treatment almost invariably leads to liquefaction and necrosis of the tumor, the likelihood of metastases is diminished.

Predictive factors of tumor response to trans-catheter treatment in cirrhotic patients with hepatocellular carcinoma: A multivariate analysis of pre-treatment findings

“…Similarly, a previous histologic study evaluating the effect of chemoembolization showed that it is effective for encapsulated HCC measuring between 2.3 and 5.5 cm in diameter [25] . TAE is usually less effective for HCC smaller than 2 cm in diameter [27,29] .…”

“…According to our results, previous pathological studies performed on liver resection following transarterial chemoembolization [22,23] demonstrated that encapsulated HCCs are more responsive to the transcatheter treatment than nonencapsulated tumors. Interestingly, a significant correlation between the thickness of the capsule and the effectiveness of tumor necrosis after chemoembolization has also been documented [24,25] . The reason for the relatively poor necrosis of tumors without capsule is not clear.…”

“…Finally, in absence of a very welldefined capsule, one must keep in mind the possibility that a negative CT image may not completely exclude the presence of capsule and may give partial information about its integrity. It is known the CT scan is limited in detecting capsular invasion of tumor cells, small satellite nodules, and tumor thrombi of the peripheral portal vein branches that are rather poorly responsive to the transcatheter treatment probably because they receive blood supply from the portal vein [23][24][25]28] .…”

Long-Term Survival of a Patient with a Large Unresectable Hepatocellular Carcinoma: Case Report and Review of the Literature~!2010-04-28~!2010-05-29~!2010-07-23~!

“…The effect of preoperative TACE in reducing local and metastatic recurrence and prolonging survival remains controversial [18]. Preoperative TACE results in better disease-free survival if complete tumor necrosis can be achieved, but actually increases the risk of recurrence if only partial necrosis is induced [19]. In addition, the size of HCC at the commencement of chemoembolization is an important prognostic factor in predicting the ultimate response and survival [20].…”

Chemical-shift Magnetic Resonance Imaging Performed after Chemoembolization of Hepatocellular Carcinoma

“…However, many questions exist regarding the effects of Lipiodol accumulation on the magnetic resonance imaging MRI signal obtained from HCC after Lp-TACE. A number of studies have indicated that high signal intensity on T1-weighted images in HCC after Lp-TACE is caused by hemorrhagic necrosis [4][5][6] , while other studies concluded that…”