Advantages and disadvantages of the intraarterial chemotherapy using a reservoir as postoperative adjuvant therapy for hepatocellular carcinoma]

We conducted a retrospective study on the efficacy and disadvantages of intraarterial chemotherapy using a reservoir (ICUR), as postoperative adjuvant therapy for hepatocellular carcinoma (HCC). One hundred and seventy HCC patients who underwent hepatectomy since 1987 to 1992 in our institute were enrolled in this study. Ninety-two patients were postoperatively treated with ICUR (group R), and seventy-eight patients without it (group N). There were no significant differences between the two groups in the preoperative evaluations of the characteristics of patients, tumors, and operative procedures. Although statistical significances were not found, disease-free rates within 1 year and cumulative survival rates appeared to be higher in group R than in group N. Patency of the catheter of reservoirs at one and two years were maintained in 80.3 and 44.1% of the patients, respectively. HCC recurred after an occlusion of the reservoir in 18 patients. In four out of these 18 patients, transcatheter arterial embolization (TAE) for recurrent tumors was not feasible, because of occlusion of the hepatic artery. TAEs for recurrent lesions would have been impossible in about 10% of all patients treated with ICUR. Thus, both the advantages and disadvantages should be taken into consideration on the indication of ICUR, and the maintainance of the catheter is important for successful ICUR.