Preoperative treatment of hepatocellular carcinoma with intra-arterial injection of 131I-labelled lipiodol

✍ Scribed by J.-L. Raoul; M. Messner; E. Boucher; J.-F. Bretagne; J.-P. Campion; K. Boudjema

• Publisher: John Wiley and Sons
• Year: 2003
• Tongue: English
• Weight: 82 KB
• Volume: 90
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.4271

✦ Synopsis

Abstract

Background

Recurrence is common after surgery for hepatocellular carcinoma (HCC).

Methods

The efficacy of, and tolerance to, preoperative intra-arterial injection of 131I-labelled lipiodol was examined in 34 patients with HCC, including 29 with cirrhosis. Twenty-five patients had a single hepatic tumour and the mean(s.d.) tumour size was 5·2(3·7) (range 2–15) cm. The patients received between one and three injections of 131I-labelled lipiodol (60 mCi per injection) before surgery. Operations included 14 liver transplants, 13 minor hepatectomies, six major hepatectomies and one exploratory laparotomy.

Results

There was one complication after lipiodol injection due to acute ischaemia of the small bowel. Three of 34 patients died within 28 days, two after transplantation and one after resection. An objective tumour response (decrease in tumour size) was observed in 19 of 34 patients, and a complete histological response in eight of 34. There was an objective tumour response or major histological necrosis of lesions in 25 of 34 patients. The 5-year survival rate was 48·4(8·0) per cent, 69·0 per cent after transplantation and 36·0 per cent in patients who underwent resection.

Conclusion

This preoperative method appeared to be well tolerated, and provided promising results in terms of macroscopic and microscopic tumour responses.