Skip to main content
SpringerLink
Log in

Segmental transarterial chemoembolization with lipiodol mixed with anticancer drugs for nonresectable hepatocellular carcinoma: follow-up CT and therapeutic results

  • Clinical Aspects in the Treatment for Operable and Session II. Chemotherapy and Radiotherapy II. 1. TAE-1
  • Hepatocellular Carcinoma, Segmental Transarterial Chemoembolization, Lipiodol, CT
  • Published:
Cancer Chemotherapy and Pharmacology Aims and scope Submit manuscript

Abstract

We developed segmental Lp-TAE, which is transcatheter hepatic sub-subsegmental, subsegmental, or segmental chemoembolization using Lipiodol introduced into the tumor-bearing hepatic sub-subsegment, subsegment, or segment as the target area. A total of 98 patients with nonresectable hepatocellular carcinoma (HCC) undergoing segmental Lp-TAE (Seg-Lp-TAE) were studied, and the relationship between the CT pattern observed after Seg-Lp-TAE (Seg-Lp-CT) and the therapeutic results obtained in those patients was evaluated. Seg-Lp-CT was classified into four types (type I, homogeneous; type II, defective; type III, inhomogeneous; and type IV, only slight accumulation, if any) according to the Lipiodol accumulation pattern observed after Seg-Lp-TAE. The cumulative nonrecurrence rates of type I were higher than those of types II–IV. The cumulative survival rates of type Ia, in which Lp accumulation is also seen around the main tumor, were the highest (93.8% at 1 year, 85.9% at 2 years, 85.9% at 3 years, and 57.3% at 4 years). The cumulative survival rates achieved with Seg-Lp-TAE were 89.2% at 1 year, 69.4% at 2 years, 58.9% at 3 years, 44.0% at 4 years, and 30.2% at 5 years, which were higher than those achieved with conventional Lp-TAE. Seg-Lp-TAE is very useful in the treatment of HCC limited to one sub-subsegment, subsegment, or segment, and it is important to choose subsubsegmental, subsegmental, subsegmental, or segmental Lp-TAE on the basis of the size and site of the tumor as well as the type and the number of feeding arteries.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Chuang VP, Wallace S (1981) Hepatic artery embolization in the treatment of hepatic neoplasms. Radiology 140: 51

    Google Scholar 

  2. Chuang VP (1988) Superselective hepatic tumor embolization with Tracker-18 catheter. J Intervent Radiol 3: 69

    Google Scholar 

  3. Couinaud C (1954) Lobes et segments hepatiques. Notes sur l'architecture anatomique et chirurgicale de foie. Presse Med 62: 709

    Google Scholar 

  4. Guo QY, Uchida H, Matsuo N, Nishimura Y, Sakaguchi H, Nishimine K, Hirohashi S, Ohue S, Nagano N, Ohishi H, Tsujii T (1993) Study on the evaluation of recurrence of HCC and the effect after transcatheter hepatic arterial embolization-fluctuations AFP values. Nippon Acta Radiol 53: 195

    Google Scholar 

  5. Konno T, Maeda H, Iwai K, Maki S, Tashiro S, Uchida M, Miyauchi Y (1985) Selective targeting of anticancer drug and simultaneous image enhancement in solid tumors by arterially administered lipid contrast medium. Cancer 54: 2367

    Google Scholar 

  6. Kuroda C, Sakurai M, Monden M, Marukawa T, Hosoki T, Tokunaga K, Wakasa K, Okamura J, Kozuka T (1991) Limitation of transcatheter arterial chemoembolization using iodized oil for small hepatocellular carcinoma. A study in resected cases. Cancer 67: 81

    Google Scholar 

  7. Livraghi T, Vettori C (1990) Percutaneous ethanol injection therapy of hepatoma. Cardiovasc Intervent Radiol 13: 146

    Google Scholar 

  8. Matsuo N, Uchida H, Soda S, Ohshima M, Nakano H, Ohishi H, Nagano N, Kitamura I, Nishimura Y, Nishimine K, Yoshioka T (1990) Histopathological study of the resected specimens after segmental Lp-TAE using Lipiodol mixed with anticancer agent for heppatocellular carcinoma—a anti-tumor effect and influence on non-tumor area. Acta Hepatol Jpn 31: 545

    Google Scholar 

  9. Matsuo N, Nishimine K, Uchida H, Nagano N, Nishimura Y, Guo QY, Sakaguchi H, Yoshioka T, Ohue S, Ohishi H, Fukui H, Tsujii T (1992) Usefulness of segmental Lp-TAE using Lipiodol mixed with anticancer agent for inoperable hepatocellular carcinoma. Jpn J Gastroenterol 89: 1415

    Google Scholar 

  10. Nakamura H, Tanaka T, Hori S, Yoshioka H, Kuroda C, Okamura J, Sakurai M (1983) Transcatheter embolization of hepatocellular carcinoma: assessment of efficacy in cases of resection following embolization. Radiology 147: 401

    Google Scholar 

  11. Nakamura H, Hashimoto T, Oi H, Sawada S (1988) Iodized oil in the portal vein after arterial embolization. Radiology 167: 415

    Google Scholar 

  12. Nishimura Y, Uchida H, Guo QY, Matsuo N, Ohue S, Nishimine K, Sakaguchi H, Ohishi H, Yoshioka T, Fukui H, Tsujii T (1991) Transcatheter arterial embolization (TAE) for 1,075 cases of hepatocellular carcinoma—evaluation of TAE using Lipiodol mixed with anticancer agents focusing on cumulative survival rate and 69 cases achieving 3-year survival. J Jpn Soc Cancer Ther 26: 2279

    Google Scholar 

  13. Ohishi H, Uchida H, Yoshimura H, Ohue S, ueda J, Katsuragi M, Matsuo N, Hosogi Y (1985) Hepatocellular carcinoma detected by iodized oil. Use of anticancer agents. Radiology 154: 25

    Google Scholar 

  14. Ohishi H, Uchida H, Ohue S, Matsuo N, Yoshioka T, Hosogi Y, Tsujii T, Yoshida H, Fukai Y, Matsumori T (1986) Diagnostic values and therapeutic effects of transcatheter arterial embolization using Lipiodol (Lp-TAE) for hepatocellular carcinoma. Comparison of medical images and resected specimens. Acta Hepatol Jpn 27: 28

    Google Scholar 

  15. Ohishi H, Yoshimura H, Uchida H, Sakaguchi H, Yoshioka T, Ohue S, Matsui T, Takaya A, Tsujii T (1989) Transcatheter arterial embolization using iodized oil (Lipiodol) mixed with an anticancer drug for the treatment of hepatocellular carcinoma. Cancer Chemother Pharmacol 23: 33

    Google Scholar 

  16. Sakaguchi H, Yoshimura H, Nishimura Y, Iwata K, Ohishi H, Uchida H (1990) Behavior of anti-cancer drug of transcatheter hepatic segmental arterial chemoembolization using Lipiodol mixed with an anti-cancer drug followed by gelatin sponge assessed by Tc-99m pertechnetate. Jpn J Cancer Chemother 17: 1725

    Google Scholar 

  17. Sasaki Y, Imaoka S, Kasugai H, Fujita M, Kawamoto S, Ishiguro S, Kojima J, Ishikawa O, Ohigashi H, Furukawa H, Koyama H, Iwanaga T (1987) A new approach to chemoembolization therapy for hepatoma using ethiodized oil, cisplatin and gelatin sponge. Cancer 60: 1194

    Google Scholar 

  18. Satoh O, Uchida H, Nishimine K, Yoshioka T, Ohishi H, Tsushima J, Ohue S, Matsuo N (1990) The analysis of superselective catheterization technique; transcatheter segmental arterial embolization using Lipiodol for hepatocellular carcinoma. Jpn J Clin Radiol 35: 685

    Google Scholar 

  19. Shiina S, Tagawa K, Unuma T, Terano A (1990) Percutaneous ethanol injection therapy for the treatment of hepatocellular carcinoma. AJR 154: 947

    Google Scholar 

  20. Uchida H, Ohishi H, Matsuo N, Sakaguchi H, Yoshioka T, Sato O, Yoshimura H (1989) Transcatheter arterial chemoembolization using Lipiodol mixed with anticancer agent (Lp-TAE) in the treatment of hepatocellular carcinoma. In: Hiramatsu K, Zeitler E, Rossi P (eds) Recent advances in interventional radiology and new vascular imaging. Elsevier, Amsterdam, p 55

    Google Scholar 

  21. Uchida H, Ohishi H, Matsuo N, Nishimine K Maeda M, Yoshioka T (1990) Transcatheter hepatic segmental arterial embolization using Lipiodol mixed with an anticancer drug and Gelfoam particles for hepatocellular carcinoma. Cardiovasc Intervent Radiol 13: 140

    Google Scholar 

  22. Yamada R, Sato M, Kawabata M, Nakatsuka H, Nakamura K, Takashima S (1983) Hepatic artery embolization in 120 patients with unresectable hepatoma. Radiology 148: 397

    Google Scholar 

  23. Yamasaki S, Hasegawa H, Makuuchi M, Takayama T (1990) Significance of systematic subsegmentectomy of the liver for hepatocellular carcinoma from the viewpoint of the long-term result. Acta Hepatol Jpn 31: 558

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Oncoradiology, Nara Medical University, 840 Shijo-cho, 634, Kashihara-city, Nara, Japan

    Kiyoshi Nishimine & Hajime Ohishi

  2. The Department of Radiology, Nara Medical University, Nara, Japan

    Hideo Uchida, Naoki Matsuo, Hiroshi Sakaguchi, Shinji Hirohashi, Yukihiro Nishimura & Qiyong Guo

  3. The Department of Radiology, Nara Prefectural Hospital, Nara, Japan

    Noritada Nagano & Tetsuya Yoshioka

  4. The Department of Radiology, Nissei Hospital, Osaka, Japan

    Shoichi Ohue

  5. The 3rd Department of Internal Medicine, Nara Medical University, Nara, Japan

    Hiroshi Fukui & Tadasu Tsujii

Authors
  1. Kiyoshi Nishimine
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hideo Uchida
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Naoki Matsuo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroshi Sakaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shinji Hirohashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yukihiro Nishimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Qiyong Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hajime Ohishi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Noritada Nagano
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Tetsuya Yoshioka
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Shoichi Ohue
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Hiroshi Fukui
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Tadasu Tsujii
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nishimine, K., Uchida, H., Matsuo, N. et al. Segmental transarterial chemoembolization with lipiodol mixed with anticancer drugs for nonresectable hepatocellular carcinoma: follow-up CT and therapeutic results. Cancer Chemother. Pharmacol. 33 (Suppl 1), S60–S68 (1994). https://doi.org/10.1007/BF00686670

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00686670

Keywords

Search

Navigation