Safety and Efficacy of Sequential Transcatheter Arterial Chemoembolization and Portal Vein Embolization prior to Major Hepatectomy for Patients with HCC

• DOI: 10.7314/apjcp.2014.15.2.703
• Publication Date: 2014-07-01T14:40:29Z
• Authors: Chuan Xu; Peng-Hua Lv; Xin-En Huang; Shu-Xiang Wang; Ling Sun; Fu-An Wang; Li-Fu Wang
• Keywords: Male; Carcinoma, Hepatocellular; Portal Vein; Liver Neoplasms; Middle Aged; Combined Modality Therapy; Embolization, Therapeutic; Catheterization; 3. Good health; 03 medical and health sciences; Hepatic Artery; 0302 clinical medicine; Case-Control Studies; Antineoplastic Combined Chemotherapy Protocols; Preoperative Care; Hepatectomy; Humans; Infusions, Intra-Arterial; Female; Chemoembolization, Therapeutic; Aged; Follow-Up Studies; Neoplasm Staging

To evaluate the safety and efficacy of sequential transcatheter arterial chemoembolization (TACE )and portal vein embolization (PVE) before major hepatectomy for patients with hepatocellur carcinoma (HCC).In this retrospective case-control study, data were collected from patients who underwent sequential TACE and PVE prior to major hemihepactectomy. Liver volumes were measured by computed tomography volumetry before TACE, and preoperation to assess degree of future remnant liver (FRL) hypertrophy and to check whether intro- or extrohepatic metastasis existed. Liver function was monitored by biochemistry after TACE, prior to and after major hepatectomy.Mean average FRL volume increased 32.3-71.4% (mean 55.4%) compared with preoperative FRL volume. After TACE, liver enzymes were elevated, but returned to normal in four weeks. During PVE and resection, no patient had intro- or extrohepatic metastasis.Sequential TACE and PVE is an effective method to improve resection opportunity, expand the scope of surgical resection, and greatly reduce postoperative intra- and extrahepatic metastasis.