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  • Title: Preoperative chemoembolization for hepatocellular carcinoma.
    Author: Morino M, Miglietta C, Grosso M, De Giuli M, Bismuth H.
    Journal: J Surg Oncol Suppl; 1993; 3():91-3. PubMed ID: 8389180.
    Abstract:
    In a group of 396 patients who had chemoembolization for hepatocellular carcinoma (HCC) between 1984 and 1991, 67 underwent surgery (segmentary/subsegmentary resections: 31; or transplantation: 36). Morbidity was limited to hepatic insufficiency (seven), arterial thrombosis (two), vasculitis (five), cholecystitis (two), and hepatic abscess (one). Perioperative mortality was 5.5% for transplantation and 6.7% for resection. Histological examination of resected specimens showed a total or subtotal tumor necrosis in 58% of the cases, and a necrosis between 50% and 80% in another 18%. Data on recurrence and long-term survival are not significant if retrospectively compared with non-chemoembolized surgically treated patients. Chemoembolization is known to be an effective palliative treatment of HCC. Its role in the preoperative setting is sustained by a 58% of total or subtotal histological necrosis. A multicentric prospective trial to evaluate the role of preoperative chemoembolization for long-term survival and recurrence of HCC is advocated.
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