Prevention of intrahepatic recurrence by adjuvant (131)iodine-labeled lipiodol after resection for hepatocellular carcinoma in HCV-related cirrhosis

• Published in: European journal of surgical oncology Vol. 33; no. 1; pp. 61 - 66
• Main Authors: Tabone, M, Vigano', L, Ferrero, A, Pellerito, R, Carbonatto, P, Capussotti, L
• Format: Journal Article
• Language: English
• Published: England 01-02-2007
• Subjects: Aged; Aged, 80 and over; Carcinoma, Hepatocellular - complications; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - surgery; Female; Follow-Up Studies; Hepacivirus - immunology; Hepatectomy; Hepatitis C Antibodies - analysis; Hepatitis C, Chronic - complications; Hepatitis C, Chronic - pathology; Hepatitis C, Chronic - virology; Humans; Incidence; Iodine Radioisotopes; Iodized Oil - therapeutic use; Italy - epidemiology; Liver Cirrhosis - etiology; Liver Cirrhosis - pathology; Liver Neoplasms - complications; Liver Neoplasms - drug therapy; Liver Neoplasms - surgery; Male; Middle Aged; Neoplasm Recurrence, Local - epidemiology; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - prevention & control; Postoperative Period; Retrospective Studies; Survival Rate - trends; Treatment Outcome; Italy
• ISSN: 0748-7983
• DOI: 10.1016/j.ejso.2006.10.039

To evaluate the impact of postoperative injection into the hepatic artery of 131-iodine-labeled lipiodol on disease-free and overall survival rates in patients who underwent liver surgical resection for hepatocellular carcinoma.
Ten consecutive patients with HCV (hepatitis C virus)-related cirrhosis who underwent liver surgical resection for hepatocellular carcinoma were treated with adjuvant injection of 131-iodine-labeled lipiodol. They were matched with 20 HCV-positive cirrhotic controls who underwent liver resection alone; patients were paired in terms of age, Child-Pugh class, tumor size, microscopic vascular invasion, tumor histological pattern, presence of satellite nodules and type of surgical resection. Recurrence was defined as the development of a new hypervascularizated nodule in the liver.
No significant differences were found between the two groups in clinical, biologic and histologic characteristics, except a lower platelet count in the control group. None of the treated patients developed an intrahepatic recurrence until the 15th month from liver resection, whereas recurrences occurred in nine of the 20 patients in the control group (p=0.01). From 18 months onwards, recurrences appeared also in the treated patients, and after 36 months of follow-up both recurrence rate and overall survival were not significantly different between the two groups.
Intrahepatic injection of 131-iodine-labeled lipiodol improves the disease-free survival rate following liver resection of hepatocellular carcinoma in the short term up to 15 months; this advantage fades, however, away after 36 months.