The Effect of Subsegmental Transcatheter Arterial Chemoembolization in Hepatocellular Carcinoma: PathologicCorrelation

ABSTRACT

PURPOSE: To assess the effectiveness of subsegmental transcatheter arterial chemoembolization(TAE) forhepatocellular carcinomas(HCCs) on the basis of tumor necrosis rate. MATERIAL AND METHODS: Between May 1996 andMarch 1998, ten patients with single HCC after subsegmental TAE underwent surgical resection. Subsegmental TAE wasperformed by injecting a mixture of lipiodol and adriamycin followed by gelatin sponge particles into the distalbranches of the subsegmental arteries. Tumor size and the extent of necrosis were analyzed in ten resectedlesions, and in all patients, complications after subsegmental TAE were assessed. RESULTS: The size of resectedtumors ranged from 1 to 5,5cm. On histological examination, complete necrosis was seen in 6 to 10 resected lesionsand 95% necrosis in three. In the remaining lesion, 85% necrosis had occured. Complete necrosis was noted in 4 of6 small HCCs(less than 3cm in diameter), while in the remaining two the extent of necrosis was 95%. Nocomplications were observed. CONCLUSION: For the treatment of HCC, subsegmental TAE is safe and effective.Curative therapy must, however, involve follow-up and repeated TAE.