VOLUMETRIC AND MORPHOLOGICAL CT PARAMETERS FOR ASSESSING PROGNOSIS AND THE EFFECT OF TREATMENT OF HEPATOCELLULAR CARCINOMAS UNDERGOING ARTERIAL CHEMOEMBOLIZATION

Purpose: To evaluate volumetric CT data as a guide for indication and assessment of prognosis for transarterial chemo-embolisation (TAE) of hepatocellular carcinomas (HCC). Material and method: 74 patients with HCC were treated with repeated TAE. 50 mg Adriblastin/m(2) body surfa ce, 50 mg cisplatin/m(2) body surface and 10 ml lipiodol were combined with 2-10 ml Spherex and injected selectively (25 cases) or supersele ctively (49 cases); in 28 patients a single injection and in 46 patien ts multiple injections were used. Results: CT findings before and afte r the procedure showed a solitary lesion in 17 patients, two lesions i n 18 patients and in 39 patients there were three or more lesions. Mea n expectation of life was 523 days (median = 372 days; 57% of one year survival probability). In 29 patients with > 75 % lipiodol retention, mean survival was 819 days; in 17 patients with < 75 % lipiodol reten tion it was 382 days; lower lipiodol retention of < 50% it was 231 day s (< 25% 192 and < 10% 152 days). A statistically significant relation ship (p < 0.0001) could be established between survival time and tumou r volume, relationship of tumour to liver volume, intratumoral lipiodo l retention, the type of tumour growth and the number of liver segment s involved. Conclusion: TAE provides best survival rates after repeate d injections of solitary HCC with tumour volumes < 50 ml and > 75 % in tra-tumoral lipiodol retention.