This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Preoperative treatment of hepatocellular carcinoma with intra‐arterial injection of 131I‐labelled lipiodol. BJS 2003; 90: 1379-1383.
Published: 24th September 2003
Authors: J.‐L. Raoul, M. Messner, E. Boucher, J.‐F. Bretagne, J.‐P. Campion, K. Boudjema et al.
Background
Recurrence is common after surgery for hepatocellular carcinoma (HCC).
Method
The efficacy of, and tolerance to, preoperative intra‐arterial injection of 131I‐labelled lipiodol was examined in 34 patients with HCC, including 29 with cirrhosis. Twenty‐five patients had a single hepatic tumour and the mean(s.d.) tumour size was 5·2(3·7) (range 2–15) cm. The patients received between one and three injections of 131I‐labelled lipiodol (60 mCi per injection) before surgery. Operations included 14 liver transplants, 13 minor hepatectomies, six major hepatectomies and one exploratory laparotomy.
Results
There was one complication after lipiodol injection due to acute ischaemia of the small bowel. Three of 34 patients died within 28 days, two after transplantation and one after resection. An objective tumour response (decrease in tumour size) was observed in 19 of 34 patients, and a complete histological response in eight of 34. There was an objective tumour response or major histological necrosis of lesions in 25 of 34 patients. The 5‐year survival rate was 48·4(8·0) per cent, 69·0 per cent after transplantation and 36·0 per cent in patients who underwent resection.
Conclusion
This preoperative method appeared to be well tolerated, and provided promising results in terms of macroscopic and microscopic tumour responses. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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