Transcatheter arterial chemoembolization in hepatocellular carcinoma. Our experience.

BACKGROUND: The results of transcatheter arterial chemoembolization (TACE) in hepatocellular carcinoma (HCC) in comparison to other treatments are investigated. METHODS: 121 patients were treated in 186 sessions in our Institute from January 1991 to January 1996. RESULTS: The mean survival rates at 1 year were 41.5 and 24.4% at 2 years. The patient's survival period was significantly longer in Child A-B patients, and in those on whom multiple sessions were performed. Personal experience in chemoembolization on HCC are better when compared to the natural history of those untreated patients but worse when compared to the data reported in literature about surgery and PEI (Percutaneous Ethanol Injection). It must be made clear though the all surgery case reports do not included class C Child patients whereas PEI is not carried out on those lesions with a diameter greater than 5 cm and plurifocal ones. Our case reports, on the other hand, as most other case reports found in the literature on chemoembolization having results similar to ours, include those patients normally not included in surgical or PEI case reports; this obviously causes the worsening of the results on global patient survival. CONCLUSIONS: Our hypothesis is that in the future the first choice in non-surgical treatment will be an association of TACE and other treatments (PEI and radiofrequency) on Child A and B patients having capsulated lesions >3 cm.