Abstract

Purpose : To evaluate long-term survival rates and prognostic factors of patients with hepatocellular carcinoma after TAE. Materials and Methods : 225 patients with hepatocellular carcinoma treated with TAE between January 1988 and December 1994 were studied. Hepatocellular carcinoma was diagnosed either histologically(n=13) orclinically on the basis of findings characteristic for hepatocellular carcinoma obtained using such as diagnostic imaging methods such as ultrasonography, CT, MRI, and angiography as well as on the basis of high serum alpha-fetoprotein level(n=212). TAE was carried out between one and six times(mean, 1.4 time) using a mixture of lipiodol and Adriamycin, together with Gelfoam. Cumulative survival rates from the day of the first TAE were obtained by the Kaplan-Meier method. Parameters likely to influence the prognosis were subjected to univariate analysis using the log-rank test Results : Cumulative survival rates at the end of the first, second, third, fourth, and fifth year were 55.9%, 32.6%, 21.9%, 17.9%, and 15.0%, respectively. The mean survival time was 727 $\pm$ 76 days. Several factors, including Child-Pugh classification, Okuda's stage, tumor size, presence of portalvein invasion by tumor, of arterio-portal shunt, and of extrahepatic metastases, catheter selection level, and number of TAE showed significant correlation with the outcome. Degrees of Lipiodol accumulation in a tumor on follow up CT were also correlated with survival rates. Conclusion : TAE is an effective measure for prolonging thepatient's life expectancy and evaluation of prognostic factor is helpful for prognosis and in deciding on the optimal therapeutic modality.

주제어

#Liver neoplasms, angiography   #Liver neoplasms, chemotherapeutic infusion   #Arteries, therapeutic blockade  

참고문헌 (25)

1. Lipiodol CT의 진단적 가치 , 박재형;최병인;조길호(등) , 대한 방사선의학회지 / v.24,pp.179-186, 1988
   
2. Hepatocellular carcinoma detected by iodized oil: Use of anticancer agents , Ohishi H;Uchida H;Yoshimura H(et al.) , Radiology / v.154,pp.25-29, 1985
   
3. Adriamycin treatment for hepatocellular carcinoma , Elio S;Rosa G;Salvatore L(et al.) , Cancer / v.56,pp.2751-2755, 1985
   
4. Transcatheter chemo-embolization effective for treating hepatocellular carcinoma: A histiopathologic study , Sakurai M;Okamura J;Kuroda C , Cancer / v.54,pp.387-392, 1984
   
5. 간세포암의 간동맥화학색전요법의 치료효과에 관한 고찰 , 이명숙;안은주;정은철;서정수;이정식 , 대한방사선의학회지 / v.27,pp.447-452, 1991
   원문보기 상세보기
6. Transcatheter embolization of hepatocellular carcinoma: Assessment of efficacy in cases of resection following embolization , Nakamura H;Tanka T;Hori S(et al.) , Radiology / v.147,pp.401-405, 1983
   
7. Lipiodol retension and massive necrosis after lipiodol-chemoembolization of hepatocellular carcinoma: Correlation between computed tomography and histopathology , Imaeda T;Yamawaki Y;Seki M(et al.) , Cardiovasc Intervent Radiol / v.16,pp.209-213, 1993
   
8. Natural history of hepatocellular carcinoma and prognosis in relation to treatment : Study of 850 patients , Okuda K;Ohtsuki T;Obata H(et al.) , Cancer / v.56,pp.918-928, 1985
   
9. Transcatheter arterial embolization for hepatocellular carcinoma: Benefits and limitations for unresectable cases with liver cirrhosis evaluated by comparison with other conservative treatments , Sato Y;Fujiwara K;Ogata I(et al.) , Cancer / v.55,pp.2822-2825, 1985
   
10. The hepatic artery , Marcovitz J , Surg Gynecol obstet / v.95,pp.644-646, 1952
    
11. Effect of repeated transcatheter arterial embolization on the survival time in patients with hepatocellular carcinoma: An analysis by the Cox proportional hazard model , Ideda K;Kumada H;Saitoh S;Arase Y;Chayama K , Cancer / v.68,pp.2150-2154, 1991
    
12. Transcatheter aterial embolization of hepatic neoplasms , Nakata K;Khan KN;Nagataki S , Crit Rev Oncol Hematol / v.13,pp.93-105, 1992
    
13. Small hepatocellular carcinoma: Treatment with subsegmental transcatheter arterial embolization , Matsui O;Kadoya M;Yashikawa J(et al.) , Radiology / v.188,pp.79-83, 1993
    
14. Distribution of iodized oil within the liver after hepatic arterial injection , Miller DL;O'Leary TJ;Girton M , Radiology / v.162,pp.849-852, 1987
    
15. Combined peripheral and central chemoembolization of liver tumors: Experience with Lipiodol-Doxorubicin and Gelatin Sponge(L-TAE) , Yoshiyuki S;Peter G;Yoshifumi T(et al.) , Cancer / v.61,pp.238-242, 1988
    
16. Use of oily contrast medium for selective drug targeting to tumor: enhanced therapeutic effect and X-ray image , Iwai K;Maeda H;Konno T , Cancer research / v.44,pp.2115-2121, 1984
    
17. Hepatocellular carcinom: Treatment with intraarterial iodized oil with and without chemotherapeutic agents , Takayasu K;Shima Y;Muramtsu Y(et al.) , Radiology / v.162,pp.345-351, 1987
    
18. 간세포암의 간동맥화학색전요법: 193명의 1년 생존률을 중심으로 , 한준구;박재형;김형석(등) , 대한방사선의학회지 / v.26,pp.624-631, 1990
    원문보기 상세보기
19. Treatment of hepatocellular carcinoma with transcatheter arterial embolization , Kenji T;Keisuke N;Yuji K(et al.) , Cancer / v.73,pp.1341-1345, 1994
    
20. 근치적 절제술을 시행한 원발성 간세포암에 대한 임상적 연구 , 이홍주;김수태 , 대한외과학회지 / v.38,pp.625-634, 1990
    
21. Studies on anticancer treatment with an oily anticancer drug injected into the ligated feeding hepatic artery for liver cancer , Nakakuma K;Tashiro S;Hiraoka T(et al.) , Cancer / v.52,pp.2193-2200, 1983
    
22. 간동맥조영술에서의 Lipiodol의 임상적 이용 , 박재형;성규보;신명진;한만청 , 대한방사선의학회지 / v.22,pp.490-494, 1986
    원문보기 상세보기
23. Effectiveness of lipiodol in transcatheter arterial embolization of hepatocellular carcinoma , Nakao N;Uchida H;Kamino K , Cancer Chemother Pharmacol / v.31,pp.S72-S76, 1992
    
24. Hepatic artery embolization in 120 patients with unresectable hepatoma , Yamada R;Sato M;Kawabata M(et al.) , Radiology / v.148,pp.397-401, 1983
    
25. Analysis of prognostotic factors in patients with hepatocellular carcinoma treated by transcatheter arterial embolization , Yamamoto K;Masuzawa M;Kato M(et al.) , Cancer Chemother pharmacol / v.31,pp.S77-S81, 1992
    

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