PREOPERATIVE CHEMOEMBOLIZATION FOR HEPATOCELLULAR-CARCINOMA

In a group of 396 patients who had chemoembolization for hepatocellula r carcinoma (HCC) between 1984 and 1991, 67 underwent surgery (segment ary/subsegmentary resections: 31; or transplantation: 36). Morbidity w as limited to hepatic insufficiency (seven), arterial thrombosis (two) , vasculitis (five), cholecystitis (two), and hepatic abscess (one). P erioperative mortality was 5.5% for transplantation and 6.7% for resec tion. Histological examination of resected specimens showed a total or subtotal tumor necrosis in 58% of the cases, and a necrosis beween 50 % and 80% in another 18%. Data on recurrence and long-term survival ar e not significant if retrospectively compared with non-chemoembolized surgically treated patients. Chemoembolization is known to be an effec tive palliative treatment of HCC. Its role in the preoperative setting is substained by a 58% of total or subtotal histological necrosis. A multicentric prospective trial to evaluate the role of preoperative ch emoembolization for long-term survival and recurrence of HCC is advoca ted.