Role of Transarterial Chemoembolization Before Liver Resection for Hepatocarcinoma
The aim of this study was to clarify whether chemoembolization (TACE) before liver resection (LR) can reduce postoperative hepatocellular carcinoma (HCC) recurrence and improve disease-free and overall survival. Eighty-nine patients with tumor-stage (TNM) I-II HCC were evaluated for LR. Patients wer...
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| Veröffentlicht in: | Liver transplantation 2000-09, Vol.6 (5), p.619-626 |
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| creator | Gerunda, Giorgio Enrico Neri, Daniele Merenda, Roberto Barbazza, Franco Zangrandi, Fabio Meduri, Francesco Bisello, Marco Valmasoni, Michele Gangemi, Antonio Faccioli, Alvise Maffei |
| description | The aim of this study was to clarify whether chemoembolization (TACE) before liver resection (LR) can reduce postoperative hepatocellular carcinoma (HCC) recurrence and improve disease-free and overall survival. Eighty-nine patients with tumor-stage (TNM) I-II HCC were evaluated for LR. Patients were prospectively allocated to LR alone or TACE plus LR based on their place of residence. Twenty nonlocal patients (24%) were selected for LR, while 69 (77.5%) local patients were selected for TACE plus LR. Following TACE, the tumor stage could be confirmed in only 20 patients (29%) who then underwent LR. Operative mortality was 0%, but in the TACE-LR group, 3 patients died of liver failure between 2 and 5 months after surgery. Early recurrence ( |
| doi_str_mv | 10.1053/jlts.2000.8312 |
| format | Article |
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Eighty-nine patients with tumor-stage (TNM) I-II HCC were evaluated for LR. Patients were prospectively allocated to LR alone or TACE plus LR based on their place of residence. Twenty nonlocal patients (24%) were selected for LR, while 69 (77.5%) local patients were selected for TACE plus LR. Following TACE, the tumor stage could be confirmed in only 20 patients (29%) who then underwent LR. Operative mortality was 0%, but in the TACE-LR group, 3 patients died of liver failure between 2 and 5 months after surgery. Early recurrence (<24 months) was 59% for LR versus 20% for TACE plus LR (P < .05). Late recurrence was 18% for LR versus 10% for TACE plus LR (P = not significant [NS]). The overall recurrence rate was 76% for LR versus 30% for TACE plus LR (P < .02). Death due to HCC recurrence was 70% for LR versus 15% for TACE plus LR (P < .05). The overall 1- and 5-year survival rates did not differ significantly (71% to 38% for LR v 85% to 43% for TACE + LR; P = NS), whereas the difference in 1- and 5-year disease-free survival was highly significant (64% to 21% for LR v 82% to 57% for TACE + LR; P < .02). TACE was able to improve the HCC staging process and significantly reduce the incidence of early and overall HCC recurrence and related death after LR; it improved the disease-free interval, but not the overall survival, due to an increase in liver failure in the first 5 months. (Liver Transpl 2000;6:619-626.)</description><identifier>ISSN: 1527-6465</identifier><identifier>EISSN: 1527-6473</identifier><identifier>DOI: 10.1053/jlts.2000.8312</identifier><identifier>PMID: 10980062</identifier><language>eng</language><publisher>Philadelphia, PA: Elsevier Inc</publisher><subject>Aged ; Arteries ; Carcinoma, Hepatocellular - surgery ; Embolization, Therapeutic - methods ; Female ; Humans ; Incidence ; Liver - pathology ; Liver - surgery ; Liver Failure - mortality ; Liver Neoplasms - pathology ; Liver Neoplasms - surgery ; Male ; Middle Aged ; Necrosis ; Neoplasm Recurrence, Local - epidemiology ; Neoplasm Recurrence, Local - prevention & control ; Postoperative Complications - mortality ; Preoperative Care ; Prospective Studies ; Survival Analysis</subject><ispartof>Liver transplantation, 2000-09, Vol.6 (5), p.619-626</ispartof><rights>2000 American Association for the Study of Liver Diseases</rights><rights>Copyright © 2000 American Association for the Study of Liver Diseases</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4943-a456959172a639c0d0eac20205ec0b2c6d29d3de88c64b1be4050a874935fd8b3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1053%2Fjlts.2000.8312$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1053%2Fjlts.2000.8312$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10980062$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gerunda, Giorgio Enrico</creatorcontrib><creatorcontrib>Neri, Daniele</creatorcontrib><creatorcontrib>Merenda, Roberto</creatorcontrib><creatorcontrib>Barbazza, Franco</creatorcontrib><creatorcontrib>Zangrandi, Fabio</creatorcontrib><creatorcontrib>Meduri, Francesco</creatorcontrib><creatorcontrib>Bisello, Marco</creatorcontrib><creatorcontrib>Valmasoni, Michele</creatorcontrib><creatorcontrib>Gangemi, Antonio</creatorcontrib><creatorcontrib>Faccioli, Alvise Maffei</creatorcontrib><title>Role of Transarterial Chemoembolization Before Liver Resection for Hepatocarcinoma</title><title>Liver transplantation</title><addtitle>Liver Transpl</addtitle><description>The aim of this study was to clarify whether chemoembolization (TACE) before liver resection (LR) can reduce postoperative hepatocellular carcinoma (HCC) recurrence and improve disease-free and overall survival. Eighty-nine patients with tumor-stage (TNM) I-II HCC were evaluated for LR. Patients were prospectively allocated to LR alone or TACE plus LR based on their place of residence. Twenty nonlocal patients (24%) were selected for LR, while 69 (77.5%) local patients were selected for TACE plus LR. Following TACE, the tumor stage could be confirmed in only 20 patients (29%) who then underwent LR. Operative mortality was 0%, but in the TACE-LR group, 3 patients died of liver failure between 2 and 5 months after surgery. Early recurrence (<24 months) was 59% for LR versus 20% for TACE plus LR (P < .05). Late recurrence was 18% for LR versus 10% for TACE plus LR (P = not significant [NS]). The overall recurrence rate was 76% for LR versus 30% for TACE plus LR (P < .02). Death due to HCC recurrence was 70% for LR versus 15% for TACE plus LR (P < .05). The overall 1- and 5-year survival rates did not differ significantly (71% to 38% for LR v 85% to 43% for TACE + LR; P = NS), whereas the difference in 1- and 5-year disease-free survival was highly significant (64% to 21% for LR v 82% to 57% for TACE + LR; P < .02). TACE was able to improve the HCC staging process and significantly reduce the incidence of early and overall HCC recurrence and related death after LR; it improved the disease-free interval, but not the overall survival, due to an increase in liver failure in the first 5 months. (Liver Transpl 2000;6:619-626.)</description><subject>Aged</subject><subject>Arteries</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Embolization, Therapeutic - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Liver - pathology</subject><subject>Liver - surgery</subject><subject>Liver Failure - mortality</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver Neoplasms - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Necrosis</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Neoplasm Recurrence, Local - prevention & control</subject><subject>Postoperative Complications - mortality</subject><subject>Preoperative Care</subject><subject>Prospective Studies</subject><subject>Survival Analysis</subject><issn>1527-6465</issn><issn>1527-6473</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1LxDAQhoMorl9Xj9KTt10nSZM2R138goKwrOeQplOMtM2adFfWX2_XingRTzMMz_syPIScU5hREPzqtenjjAHALOeU7ZEjKlg2lWnG9392KSbkOMZXAEqFgkMyoaByAMmOyGLhG0x8nSyD6aIJPQZnmmT-gq3HtvSN-zC9811yg7UPmBRugyFZYET7dR6OyQOuTO-tCdZ1vjWn5KA2TcSz73lCnu9ul_OHafF0_zi_LqY2VSmfmlRIJRTNmJFcWagAjWXAQKCFkllZMVXxCvPcyrSkJaYgwORZqrioq7zkJ-Ry7F0F_7bG2OvWRYtNYzr066gzxtKMSTWAsxG0wccYsNar4FoTtpqC3lnUO4t6Z1HvLA6Bi-_mddli9QsftQ1ANgLvrsHtP3W6WIphlyAoH5L5mMTBzMZh0NE67CxWLgxKdeXdX199AuRukg4</recordid><startdate>200009</startdate><enddate>200009</enddate><creator>Gerunda, Giorgio Enrico</creator><creator>Neri, Daniele</creator><creator>Merenda, Roberto</creator><creator>Barbazza, Franco</creator><creator>Zangrandi, Fabio</creator><creator>Meduri, Francesco</creator><creator>Bisello, Marco</creator><creator>Valmasoni, Michele</creator><creator>Gangemi, Antonio</creator><creator>Faccioli, Alvise Maffei</creator><general>Elsevier Inc</general><general>W.B. Saunders</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200009</creationdate><title>Role of Transarterial Chemoembolization Before Liver Resection for Hepatocarcinoma</title><author>Gerunda, Giorgio Enrico ; Neri, Daniele ; Merenda, Roberto ; Barbazza, Franco ; Zangrandi, Fabio ; Meduri, Francesco ; Bisello, Marco ; Valmasoni, Michele ; Gangemi, Antonio ; Faccioli, Alvise Maffei</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4943-a456959172a639c0d0eac20205ec0b2c6d29d3de88c64b1be4050a874935fd8b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Aged</topic><topic>Arteries</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>Embolization, Therapeutic - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Liver - pathology</topic><topic>Liver - surgery</topic><topic>Liver Failure - mortality</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Necrosis</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Neoplasm Recurrence, Local - prevention & control</topic><topic>Postoperative Complications - mortality</topic><topic>Preoperative Care</topic><topic>Prospective Studies</topic><topic>Survival Analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gerunda, Giorgio Enrico</creatorcontrib><creatorcontrib>Neri, Daniele</creatorcontrib><creatorcontrib>Merenda, Roberto</creatorcontrib><creatorcontrib>Barbazza, Franco</creatorcontrib><creatorcontrib>Zangrandi, Fabio</creatorcontrib><creatorcontrib>Meduri, Francesco</creatorcontrib><creatorcontrib>Bisello, Marco</creatorcontrib><creatorcontrib>Valmasoni, Michele</creatorcontrib><creatorcontrib>Gangemi, Antonio</creatorcontrib><creatorcontrib>Faccioli, Alvise Maffei</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Liver transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gerunda, Giorgio Enrico</au><au>Neri, Daniele</au><au>Merenda, Roberto</au><au>Barbazza, Franco</au><au>Zangrandi, Fabio</au><au>Meduri, Francesco</au><au>Bisello, Marco</au><au>Valmasoni, Michele</au><au>Gangemi, Antonio</au><au>Faccioli, Alvise Maffei</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Role of Transarterial Chemoembolization Before Liver Resection for Hepatocarcinoma</atitle><jtitle>Liver transplantation</jtitle><addtitle>Liver Transpl</addtitle><date>2000-09</date><risdate>2000</risdate><volume>6</volume><issue>5</issue><spage>619</spage><epage>626</epage><pages>619-626</pages><issn>1527-6465</issn><eissn>1527-6473</eissn><abstract>The aim of this study was to clarify whether chemoembolization (TACE) before liver resection (LR) can reduce postoperative hepatocellular carcinoma (HCC) recurrence and improve disease-free and overall survival. Eighty-nine patients with tumor-stage (TNM) I-II HCC were evaluated for LR. Patients were prospectively allocated to LR alone or TACE plus LR based on their place of residence. Twenty nonlocal patients (24%) were selected for LR, while 69 (77.5%) local patients were selected for TACE plus LR. Following TACE, the tumor stage could be confirmed in only 20 patients (29%) who then underwent LR. Operative mortality was 0%, but in the TACE-LR group, 3 patients died of liver failure between 2 and 5 months after surgery. Early recurrence (<24 months) was 59% for LR versus 20% for TACE plus LR (P < .05). Late recurrence was 18% for LR versus 10% for TACE plus LR (P = not significant [NS]). The overall recurrence rate was 76% for LR versus 30% for TACE plus LR (P < .02). Death due to HCC recurrence was 70% for LR versus 15% for TACE plus LR (P < .05). The overall 1- and 5-year survival rates did not differ significantly (71% to 38% for LR v 85% to 43% for TACE + LR; P = NS), whereas the difference in 1- and 5-year disease-free survival was highly significant (64% to 21% for LR v 82% to 57% for TACE + LR; P < .02). TACE was able to improve the HCC staging process and significantly reduce the incidence of early and overall HCC recurrence and related death after LR; it improved the disease-free interval, but not the overall survival, due to an increase in liver failure in the first 5 months. (Liver Transpl 2000;6:619-626.)</abstract><cop>Philadelphia, PA</cop><pub>Elsevier Inc</pub><pmid>10980062</pmid><doi>10.1053/jlts.2000.8312</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Liver transplantation, 2000-09, Vol.6 (5), p.619-626 |
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| subjects | Aged Arteries Carcinoma, Hepatocellular - surgery Embolization, Therapeutic - methods Female Humans Incidence Liver - pathology Liver - surgery Liver Failure - mortality Liver Neoplasms - pathology Liver Neoplasms - surgery Male Middle Aged Necrosis Neoplasm Recurrence, Local - epidemiology Neoplasm Recurrence, Local - prevention & control Postoperative Complications - mortality Preoperative Care Prospective Studies Survival Analysis |
| title | Role of Transarterial Chemoembolization Before Liver Resection for Hepatocarcinoma |
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