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Transcatheter arterial chemoembolization for hepatocellular carcinoma in patients with cirrhosis: evaluation of damage to nontumorous liver tissue-long-term prospective study

Radiology. 2000 Apr;215(1):123-8. doi: 10.1148/radiology.215.1.r00ap21123.

Abstract

Purpose: To evaluate damage to cirrhotic liver tissue after transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC).

Materials and methods: TACE was performed in 111 patients with HCC that involved less than 30% of the liver. Baseline liver function was evaluated with Child-Pugh scores and other indicators. Eighty-two patients had Child-Pugh class A disease, 27 had class B disease, and two had class C disease. All patients underwent chemotherapy followed by gelatin sponge particle embolization in the proper ("complete" embolization; n = 69) or right or left main ("partial" embolization; n = 42) hepatic artery. Liver function was assessed 4 months later, and 95 patients underwent a second TACE (complete embolization in 57, partial in 38). Liver function was again assessed 4 months later in 60 patients.

Results: No patient died. Child-Pugh scores increased in all patients from a mean 5.96 to 6.28 (not significant) and 6.51 (P =. 05) after first and second TACEs, respectively. In patients with class A disease, scores increased from a mean 5.37 to 5.73 (P =.01) and 5.89 (P =.001) after first and second TACEs, respectively; in patients with class B disease, scores changed from a mean of 7.48 to 7.67 and 7.30 after first and second TACEs, respectively (not significant).

Conclusion: TACE does not induce significant long-term worsening of liver function in patients with class A or B cirrhosis.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antibiotics, Antineoplastic / administration & dosage
  • Carcinoma, Hepatocellular / therapy*
  • Catheterization, Peripheral
  • Chemoembolization, Therapeutic* / instrumentation
  • Chemoembolization, Therapeutic* / methods
  • Contrast Media / administration & dosage
  • Doxorubicin / administration & dosage
  • Female
  • Follow-Up Studies
  • Gelatin Sponge, Absorbable / administration & dosage
  • Hemostatics / administration & dosage
  • Hepatic Artery
  • Humans
  • Iodized Oil / administration & dosage
  • Iopamidol / administration & dosage
  • Liver / drug effects
  • Liver / pathology
  • Liver / physiopathology
  • Liver Cirrhosis / classification
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / physiopathology
  • Liver Neoplasms / therapy*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prospective Studies
  • Remission Induction
  • Retreatment

Substances

  • Antibiotics, Antineoplastic
  • Contrast Media
  • Hemostatics
  • Iodized Oil
  • Doxorubicin
  • Iopamidol