POSTOPERATIVE PROPHYLACTIC LIPIODOLIZATION REDUCES THE INTRAHEPATIC RECURRENCE OF HEPATOCELLULAR-CARCINOMA

BACKGROUND: To determine a feasible postoperative adjuvant chemotherap y for patients with hepatocellular carcinoma, orally-administered chem otherapy (OC) and prophylactic lipiodolization (selective regional can cer chemotherapy using lipid contrast medium plus an anticancer drug) (PL) were compared prospectively. PATIENTS AND METHODS: Forty-eight pa tients who had undergone hepatic resection from 1989 to 1992 were divi ded into three groups: the control group (n = 19), given no chemothera py; the OC group (n = 12), given 300 to 400 mg/d of 5-FU derivatives ( either 1-hexylcarbamoyl-5-fluorouracil or uracil and tegafur, mean tot al dosage: 188 g, mean administrative duration: 18 months); and the PL group (n = 17), who underwent prophylactic lipiodolization 1.8 times on average using a 44-mg mean dose of epirubicin per treatment. RESULT S: No statistical differences were found either in the 25 variables st udied as a background analysis, or among the survival curves of the 3 groups. Recurrence was found in 23 remnant livers of the 48 patients, The 3-year disease-free survival rate was 15%, 50%, and 86% in the con trol, OC, and PL groups, respectively. The disease-free survival curve of the PL group Tvas significantly higher compared to either the cont rol (P = 0.001) or the OC group (P = 0.025). CONCLUSIONS: Prophylactic Lipiodolization was found to be an effective treatment for patients w ith hepatocellular carcinoma for reducing intrahepatic recurrence afte r resection.