Transcatheter arterial infusion chemotherapy prior to radiofrequency thermal ablation for single hepatocellular carcinoma reduces the risk of intrahepatic distant recurrence

Nishikawa,Hiroki; Osaki,Yukio; Kita,Ryuichi; Kimura,Toru; Inuzuka,Tadashi; Takeda,Haruhiko; Nakajima,Jun; Matsuda,Fumihiro; Sakamoto,Azusa; Henmi,Shinichiro; Hatamaru,Keiichi; Saito,Sumio; Nasu,Akihiro

doi:10.3892/ijo.2012.1512

Transcatheter arterial infusion chemotherapy prior to radiofrequency thermal ablation for single hepatocellular carcinoma reduces the risk of intrahepatic distant recurrence

Authors:
- Hiroki Nishikawa
- Yukio Osaki
- Ryuichi Kita
- Toru Kimura
- Tadashi Inuzuka
- Haruhiko Takeda
- Jun Nakajima
- Fumihiro Matsuda
- Azusa Sakamoto
- Shinichiro Henmi
- Keiichi Hatamaru
- Sumio Saito
- Akihiro Nasu
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Affiliations: Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka 543-0027, Japan
Published online on: June 11, 2012 https://doi.org/10.3892/ijo.2012.1512
Pages: 903-909

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Abstract

The aim of the present study was to elucidate the effectiveness of transcatheter arterial infusion chemotherapy (TAI) of the whole liver using an epirubicin-mitomycin-lipiodol emulsion, prior to radiofrequency thermal ablation (RFA), in preventing intrahepatic distant recurrence (IDR) from single hepatocellular carcinoma (HCC). Of the 269 consecutive patients who underwent RFA in our institute for single HCC, a total of 182 patients were analyzed in the present study. The primary endpoint was comparison of the post-RFA IDR-free survival rates in patients treated using TAI with an epirubicin-mitomycin-lipiodol emulsion via the proper hepatic artery (TAI-EML) prior to RFA, and patients that received lipiodol infusion-alone prior to RFA. The secondary endpoints were local tumor progression (LTP) and overall survival (OS). Lipiodol infusion-alone prior to RFA was performed in 88 patients and TAI-EML prior to RFA in 94 patients. The mean tumor size was 2.06 cm (range, 0.9-3.2 cm) in the TAI group and 1.97 cm (range, 0.9-3.3 cm) in the lipiodol-alone group, respectively. The cumulative IDR-free survival rates at 1, 2 and 3 years were 74.0, 50.8 and 34.9%, respectively, in the lipiodol-alone group, and 90.8, 74.8 and 70.0%, respectively, in the TAI group (P<0.001). In terms of the OS, there was a significant difference between these two groups (P=0.048), although there was no significant difference in terms of the LTP (P=0.145). We concluded that TAI-EML prior to RFA appears to be useful in reducing post-RFA IDR and may contribute to improved survival rates.

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