Oily contrast medium used for chemoembolization in the palliative treatment of extensive inoperable primary hepatocellular carcinomas

: Transcatheter arterial oily chemoembolization using cytostatics mixed with lymphographic contrast agent with or without Gelfoam embolization seems currently to be the most suitable treatment for unresectable hepatocellular carcinomas (HCC). 5 patients with inoperable, biopsy proven huge HCC (average size 404 cm2) were treated by multiple cycles (3-7, average 4.6 cycles) of a triple drug combination including doxorubicin, cisplatin and mitomycin-C together with Lipiodol. In 13/23 cycles the lipiodolization was complemented by Gelfoam embolization increasing the efficacy of treatment. The hypervascular HCC-s showed marked reduction in size (degree of regression was 33-66%, average 55%). The median follow-up was 1918 (13-36 months). Three patients are still alive with follow-up ranging from 15-36 months (average 23 months) despite the progression of the disease. One patient died of tumorous cachexia 13 months after initial treatment, while another one, who developed partial remission, lost his life in a road accident 17 months after his first cycle.