SEQUENTIAL TRANSARTERIAL CHEMOEMBOLIZATION FOR UNRESECTABLE ADVANCED HEPATOCELLULAR-CARCINOMA

Purpose: The aim of this prospective study was to evaluate the feasibi lity, safety, and efficacy of sequential transarterial chemoembolizati on (TACE) for patients with unresectable advanced hepatocellular carci noma (HCC). Methods: Twenty-one consecutive patients with unresectable T3 and T4 HCC were treated by sequential TACE (median time interval b etween treatments 7 weeks) up to six times with an emulsion of lipiodo l, epirubicin, and cisplatin. All TACE procedures were performed as un ilobar or whole-liver chemoembolization. Results: An average of 3.9 TA CE procedures were performed per patient. One primary and two secondar y technical failures occurred. No procedural death was observed. After exclusion of the patient with the primary technical failure and 3 pat ients with extrahepatic disease, the survival rates for the remaining 17 patients at 6, 12, 18, and 24 months were 70.6%, 52.9%, 44.1%, and 33.1%, respectively. Conclusion: Sequential TACE is a safe procedure i n patients with unresectable advanced HCC and feasible in most cases. It seems to prolong the survival time compared with historical series of untreated patients.