The Effect of the Degree of Tumor Necrosis on Survival in Patients with Hepatocellular carcinoma Treated with Curative Resection Following Preoperative Transcatheter Arterial Therapy

Lee, Chang Mok; Yoon, Dong Sup; Kwon, Sung Won; Chi, Hoon Sang; Kim, Byong Ro

Abstract

PURPOSE
To investigate the effect of patient and tumor factors on the degree of tumor necrosis and the effect of the degree of the tumor necrosis on the survival in patients treated with curative resection following transcatheter arterial therapy.
MATERIALS AND METHODS
90 patients diagnosed as having hepatocellular carcinoma and treated with curative resection following transcatheter arterial therapy at Yonsei Medical Center between January 1986 and December 1995. The subjects were classified into four groups: 100% necrosis group (Group I, n=29), over 95% necrosis group (Group II, n=28), 50-95% necrosis group (Group III, n=13) and below 50% necrosis group (Group IV, n=20). The factors which affect on the necrosis of the tumor were compared. The overall and disease-free survival rates according to the degree of tumor necrosis were illustrated.
RESULTS
There was no statistical difference in the degree of the tumor necrosis according to age, sex, HBsAg, g-FP, liver cirrhosis, tumor size and morphological classification. In the comparison between the preoperative transcatheter arterial therapies, however, transcatheter arterial chemo-oily embolization (TACOE), which used the injection of the mixture of 3 10 cc Lipiodol and 30-50 mg Adriamycin followed by Gelfoam em- bolization, showed the higher number of 100% necrosis and over 95% necrosis cases. The 1, 3 year overall survival rates were greater for Group I, although not statistically significant. The 1, 5 year disease-free survival rates were greater for Group I, although not statistically significant.
CONCLUSION
In the preoperative transcatheter arterial embolization, TACOE was most effective to get total necrosis of tumor. However overall survival and disease free survival were not affected by the amount of tumor necrosis.