Liver transplantation for hepatocellular carcinoma: Results with preoperative chemoembolization

✍ Scribed by Venook, Alan P. ;Ferrell, Linda D. ;Roberts, John P. ;Emond, Jean ;Frye, John W. ;Ring, Ernest ;Ascher, Nancy L. ;Lake, John R.

• Publisher: Wiley (John Wiley & Sons)
• Year: 1995
• Tongue: English
• Weight: 572 KB
• Volume: 1
• Category: Article
• ISSN: 1074-3022
• DOI: 10.1002/lt.500010409

✦ Synopsis

patients who met the following criteria-hepatic tumor unresectable because of location or inadequate liver reserve, no metastases, HBsAg negative, no tumor larger than 5 cm in diameter, and no more than three tumors-were enrolled prospectively in a protocol employing preoperative chemoembolization to assess whether orthotopic liver transplantation (OLT) could cure a majority of highly selected patients with hepatocellular carcinoma (HCC). Thirteen patients had biopsy-proven HCC, 2 had the fibrolamellar variant, and 2 had radiological findings of HCC but no biopsy confirmation. Fourteen had underlying liver disease. All arteriographically apparent lesions were chemoembolized using a mixture including Gelfoam powder, doxorubicin, mitomycin-c, and cisplatin. Eight patients with poor hepatic reserve were chemoembolized when a donor organ became available, whereas 9 patients were chemoemboepatocellular carcinoma (HCC) is one of the H most common cancers worldwide, with more than 1,000,000 patients diagnosed each year.' Because the vast majority of cases occur in patients with underlying liver disease, curative resection is possible in the minority. For example, even with the screening of hepatitis B surface antigen positive (HBsAg +) patients and an aggressive surgical approach, only 40% of patients in Shanghai are surgical candidates and long-term survival rate is less than 15%.* Although there are many approaches to patients with unresectable HCC that may diminish the volume of tumor cells-intrahepatic ~hemotherapy,~ chemoem-b~lization,~ percutaneous tumoral alcohol inje~tion,~ From the *Department ofhledicine, the fDepartment ofpathology, the ?Department of Surgery, the §School of Pharmacy, and the