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Cancer Chemotherapy and Pharmacology

, Volume 31, Supplement 1, pp S7–S12 | Cite as

Clinicopathological study on combination therapy consisting of arterial infusion of lipiodol-dissolved SMANCS and transcatheter arterial embolization for hepatocellular carcinoma

  • Kenji Jinno
  • Shosuke Moriwaki
  • Minoru Tanada
  • Toshihiro Wada
  • Koichi Mandai
  • Yoshio Okada
Session I: Treatment for Operable Patients Surgery and Combined Modalities Hepatocellular Carcinoma, Lipiodol Transcatheter Arterial Embolizatior

Summary

Combination therapy (LpTAE) consisting of arterial infusion of a lipophilic anticancer drug, SMANCS, dissolved in an oily lymphographic agent, lipiodol (LPD), and transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC) was studied with special reference to the pathological findings. A total of 32 patients were subjected to surgical resection after LpTAE. The pattern of LPD deposition in the tumor was examined by CT scan (Lipiodol CT, LpCT) at 7 days and/or 1 month after LpTAE. The resected materials were examined radiographically with soft X-rays and histologically. LPD was deposited in tiny daughter nodules with a diameter of less than 5 mm and in tumor thrombi as well as in the main tumors, which showed necrotic change. Part of the LPD flowed out from the main tumor via the drainage vein and was deposited in the capsular invasion, resulting in necrosis. LPD accumulated almost exclusively within the blood spaces of trabecular-type HCC, creating a pattern corresponding to a cast of the tumor vessels, which showed prominent necrossi. On the other hand, LPD was not deposited in scirrhous, compact, or well-differentiated HCC, which showed little or no necrosis. It was demonstrated that LpCT images, which accurately depicted the existence and the extent of LPD deposition and necrosis in peutic effect. Our findings indicate that LpTAE and LpCT are valuable for the diagnosis and treatment of HCC and should play a central role in systemic therapeutic approaches to this disease.

Keywords

Hepatocellular Carcinoma Surgical Resection Anticancer Drug Pathological Finding Tumor Thrombus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Gibson JB, Sobin LH (1978) Histological typing of tumors of the liver, biliary tract and pancreas. WHO, Geneva, p 20Google Scholar
  2. 2.
    Hsu HC, Wei TC, Tsang YM, Wu MZ, Lin YH, Chuang SM (1986) Histologic assessment of resected hepatocellular carcinoma after transcatheter hepatic arterial embolization. Cancer 57:1184Google Scholar
  3. 3.
    Jinno K, Moriwaki S (1988) Intra-arterial infusion therapy with anticancer agents/lipiodol. In: Cancer of the liver: diagnosis and treatment (in Japanese). Kodansha, Tokyo, p 79Google Scholar
  4. 4.
    Jinno K, Tokuyama K, Yumoto Y, Araki Y, Fujita Y, Ishimitsu T, Fukuda K, Kusumoto G, Moriwaki S, Maeda H, Konno T (1984) Intra-arterial injection of lipophilic anticancer drug (SMANCS/lipiodol) and transcatheter arterial embolization combination therapy in hepatocellular carcinoma (in Japanese). Igaku No Ayumi 128:565Google Scholar
  5. 5.
    Jinno K, Moriwaki S, Tokuyama K, Yumoto Y, Fukuda K, Maeda H, Konno T (1986) Clinico-pathologic study on selective accumulation of lipiodol, an oily contrast medium, in hepatocellular carcinoma (in Japanese). Acta Hepatol Jpn 27:471Google Scholar
  6. 6.
    Jinno K, Tokuyama K, Yumoto Y, Wada T, Okamoto T, Kobashi H, Moriwaki S, Tanada M, Maeda H, Konno T (1988) Significance of lipiodol-CT in the evaluation of therapeutic effects of Lp-TAE for hepatocellular carcinoma. Clinicopathologic study (in Japanese). J Jpn Soc Cancer Ther 23:1660Google Scholar
  7. 7.
    Kanematsu T, Inokuchi K, Sugimachi K, Furuta T, Sonoda T, Tamura S, Hasuo K (1984) Selective effect of lipiodolized antitumor agents. J Surg Oncol 25:218Google Scholar
  8. 8.
    Kasugai H, Kojima J, Tatsuta M, Okuda S, Sasaki Y, Imaoka S, Fujita M, Ishiguro S (1989) Treatment of hepatocellular carcinoma by transcatheter arterial embolization combined with intraarterial infusion of a mixture of cisplatin and ethiodized oil. Gastroenterology 97:965Google Scholar
  9. 9.
    Konno T, Maeda H, Iwai K, Tashiro S, Maki S, Morinaga T, Mochinaga M, Hiraoka T, Yokoyama I (1983) Effect of arterial administration of high-molecular weight anti-cancer agent, SMANCS, with lipid lymphographic agent on hepatoma: a preliminary report. Eur J Clin Oncol 19:1053Google Scholar
  10. 10.
    Livrahgi T, Festi D, Monti F, Salmi A, Vettori C (1986) US-guided percutaneous alcohol injection of small hepatic and abdominal tumors. Radiology 161:309Google Scholar
  11. 11.
    Maeda H, Takeshita J, Kanemaru R (1979) A lipophilic derivative of neocarzinostatin. Int J Pept Protein Res 14:81Google Scholar
  12. 12.
    Ryu M, Yamamoto Y, Yamamoto H, Watanabe Y, Nagashima T, Ariga T, Juan IK, Okada M, Sato H (1984) Evaluation of the effect of transcatheter arterial embolization (TAE) as a preoperative therapy for minute hepatocellular carcinomas (in Japanese) Acta Hepatol Jpn 25:881Google Scholar
  13. 13.
    Shibata J, Fujiyama S, Sato T, Kishimoto S, Fukushima S, Nakano M (1989) Hepatic arterial, injection chemotherapy with cisplatin suspended in an oily lymphographic agent for hepatocellular carcinoma. Cancer 64:1586Google Scholar
  14. 14.
    Shimamura Y., Gunvén P, Takenaka Y, Shimizu H, Shima Y, Akimoto H, Arima K, Takahashi A, Kitaya T, Matsuyama T, Hasegawa H, (1988) Combined peripheral and central chemoembolization of liver tumors. Experience with lipiodol-doxorubicin and gelatin sponge (L-TAE). Cancer 61:238Google Scholar
  15. 15.
    Yamada R, Sato M, Kawabata M, Nakatsuka H, Nakamura K, Takashima S (1983) Hepatic arterial embolization in 120 patients with unresectable hepatoma. Radiology 148:397Google Scholar
  16. 16.
    Yumoto Y, Jinno K, Tokuyama K, Araki Y, Ishimitsu T, Maeda H, Konno T, Iwamoto S, Ohnishi K, Okuda K (1985) Hepatocellular carcinoma detected by iodized oil. Radiology 154:19Google Scholar

Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • Kenji Jinno
    • 1
  • Shosuke Moriwaki
    • 3
  • Minoru Tanada
    • 2
  • Toshihiro Wada
    • 1
  • Koichi Mandai
    • 3
  • Yoshio Okada
    • 4
  1. 1.Department of Internal MedicineShikoku Cancer Center HospitalMatsuyamaJapan
  2. 2.Department of SurgeryShikoku Cancer Center HospitalMatsuyamaJapan
  3. 3.Department of PathologyShikoku Cancer Center HospitalMatsuyamaJapan
  4. 4.Okayama Prefectural Junior CollegeOkayamaJapan

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