POSTOPERATIVE ADJUVANT HEPATIC ARTERIAL INFUSION OF LIPIODOL CONTAINING ANTICANCER DRUGS IN PATIENTS WITH HEPATOCELLULAR-CARCINOMA

Vascular invasion and intrahepatic metastasis by hepatocellular carcin oma are important factors predisposing to tumor recurrence. Recurrence s of this malignancy occur frequently in residual liver, and its preve ntion is one of the most important factors in obtaining better surgica l survival. Fifty patients who underwent hepatectomy for invasive hepa tocellular carcinoma with vascular invasion and/or intrahepatic metast ases were studied to evaluate the effect of adjuvant bolus hepatic art erial infusion of iodized poppyseed oil (Lipiodol) containing anticanc er drugs in preventing recurrence and in prolonging survival. Patients were assigned to two treatment groups. Twenty-three of the fifty pati ents received adjuvant bolus infusion of Lipiodol containing doxorubic in and mitomycin C, whereas 27 patients received no therapy. The disea se-free survival rate for the patients who received adjuvant therapy w as significantly better (p < 0.05) than that for those who did not whe n measured at 172, 516, 688 and 860 days after hepatectomy, and the di sease-free survival curve for patients with adjuvant therapy was signi ficantly (p = 0.0237) better than that without adjuvant therapy. The c umulative survival rates and curves were not significantly different b etween the two groups. While adjuvant hepatic arterial infusion of Lip iodol containing anticancer drugs was effective in improving disease-f ree survival, the effect was not satisfactory. Further trials of adjuv ant chemotherapy are required to improve the surgical survival of hepa tocellular carcinoma patients.