Rationale and objectives: This retrospective study was undertaken to determine clinically and histopathologically the efficacy of preoperative transcatheter hepatic arterial embolization (PTHAE) in liver malignancies.
Methods: Ten patients underwent either single or multiple episodes of PTHAE with lipiodol in an emulsion with chemotherapeutic agents. Four of the patients were thought to be unresectable before embolotherapy. Eight patients had hepatocellular carcinoma, one had cholangiocarcinoma, and one metastatic colon carcinoma. All patients subsequently underwent surgical resection. Histologic observations were made in all resected specimens.
Results: No viable tumor cells were recognized in three of the ten specimens, whereas extensive necrosis (70%-95%) was seen in the remaining seven patients. The four patients with tumors that were that to be unresectable before PTHAE had significant reduction in tumor burden (60%-80%) and were thought to be resectable after their embolization. Effectiveness on satellite nodules, thrombi in the portal veins, and intracapsular infiltration was histologically verified. The mean and median survival times to date have been 24.8 and 24.5 months, respectively.
Conclusions: Preoperative transcatheter hepatic arterial embolization is a useful procedure that, in this small patient series, converted unresectable liver tumors into potentially resectable lesions.