Transcatheter Arterial Chemoembolization for Treatment of Small Hepatocellular Carcinoma: Comparison of Surgical and Supportive Treatments

To study the usefulness of transcatheter arterial chemoembolization (TACE) for small hepatocellular carcinoma (HCC), 139 patients who were treated with TACE, surgery or supportive medicine were reviewed. Forty- four patients underwent TACE therapy. Their one-year and five-year survival rates were 95% and 24%, respectively. The survival values of patients who had neither clinical symptoms nor signs of liver disease, good liver function and lower serum aipha-fetoprotein (AFP) concentration were significantly higher than those with symptoms, poor liver function and high serum AFP. Seventy patients underwent partial hepatectomy with 89% and 40% one- and five-year survival rates,respectively Ten of the supportive treatment patients with good liver function had one- and five-year survival rates of 80% and 10%, respectively. The one, two- and three-year survival rates of the remaining 15 hepatic decompensation patients were 47%, 24% and 0%, respectively. Since in a majority of patients with small HCCs having an association with liver cirrhosis, preservation of good liver function for such patients is much important for their survival. TACE is effective in treatment of small HCCs over a relatively short period, however, delaying deterioration of liver function maybe an unexpected complication of multiple TACE therapy, especially in cases of lobar embolization.