[Volumetric and morphological CT parameters for assessing prognosis and treatment control in hepatocellular carcinoma undergoing arterial chemoembolization].

PURPOSE

To evaluate volumetric CT data as a guide for indication and assessment of prognosis for transarterial chemo-embolisation (TAE) of hepatocellular carcinomas (HCC).

MATERIAL AND METHOD

74 patients with HCC were treated with repeated TAE. 50 mg Adriblastin/m2 body surface, 50 mg cisplatin/m2 body surface and 10 ml lipiodol were combined with 2-10 ml Spherex and injected selectively (25 cases) or superselectively (49 cases); in 28 patients a single injection and in 46 patients multiple injections were used.

RESULTS

CT findings before and after the procedure showed a solitary lesion in 17 patients, two lesions in 18 patients and in 39 patients there were three or more lesions. Mean expectation of life was 523 days (median = 372 days; 57% of one year survival probability). In 29 patients with > 75% lipiodol retention, mean survival was 819 days; in 17 patients with < 75% lipiodol retention it was 382 days; lower lipiodol retention of < 50% it was 231 days (< 25% 192 and < 10% 152 days). A statistically significant relationship (p < 0.0001) could be established between survival time and tumour volume, relationship of tumour to liver volume, intratumoral lipiodol retention, the type of tumour growth and the number of liver segments involved.

CONCLUSION

TAE provides best survival rates after repeated injections of solitary HCC with tumour volumes < 50 ml and > 75% intra-tumoral lipiodol retention.