A PROSPECTIVE RANDOMIZED TRIAL OF THE PREVENTIVE EFFECT OF PREOPERATIVE TRANSCATHETER ARTERIAL EMBOLIZATION AGAINST RECURRENCE OF HEPATOCELLULAR-CARCINOMA

To clarify whether pre-operative transcatheter arterial embolization ( TAE) improves survival after hepatectomy, a prospective randomized com parative 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 c hosen as subjects and divided into two groups: hepatectomy with (group A: n = 50) and without (group B: n = 47) pre-operative TAE, The perio d of observation of the patients who survived the surgery was between 4.0 and 6.6 years, The randomization appeared to have provided well-ba lanced groups of patients and the clinico-pathological characteristics of the two groups were quite similar, The necrotic part of the cancer ous 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 gr oups 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 thro mbus and that pre-operative TAE does not improve post-operative surviv al.