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Clinicopathological study on combination therapy consisting of arterial infusion of lipiodol-dissolved SMANCS and transcatheter arterial embolization for hepatocellular carcinoma

  • Session I: Treatment for Operable Patients Surgery and Combined Modalities
  • Hepatocellular Carcinoma, Lipiodol Transcatheter Arterial Embolizatior
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Summary

Combination therapy (LpTAE) consisting of arterial infusion of a lipophilic anticancer drug, SMANCS, dissolved in an oily lymphographic agent, lipiodol (LPD), and transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC) was studied with special reference to the pathological findings. A total of 32 patients were subjected to surgical resection after LpTAE. The pattern of LPD deposition in the tumor was examined by CT scan (Lipiodol CT, LpCT) at 7 days and/or 1 month after LpTAE. The resected materials were examined radiographically with soft X-rays and histologically. LPD was deposited in tiny daughter nodules with a diameter of less than 5 mm and in tumor thrombi as well as in the main tumors, which showed necrotic change. Part of the LPD flowed out from the main tumor via the drainage vein and was deposited in the capsular invasion, resulting in necrosis. LPD accumulated almost exclusively within the blood spaces of trabecular-type HCC, creating a pattern corresponding to a cast of the tumor vessels, which showed prominent necrossi. On the other hand, LPD was not deposited in scirrhous, compact, or well-differentiated HCC, which showed little or no necrosis. It was demonstrated that LpCT images, which accurately depicted the existence and the extent of LPD deposition and necrosis in peutic effect. Our findings indicate that LpTAE and LpCT are valuable for the diagnosis and treatment of HCC and should play a central role in systemic therapeutic approaches to this disease.

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References

  1. Gibson JB, Sobin LH (1978) Histological typing of tumors of the liver, biliary tract and pancreas. WHO, Geneva, p 20

    Google Scholar 

  2. Hsu HC, Wei TC, Tsang YM, Wu MZ, Lin YH, Chuang SM (1986) Histologic assessment of resected hepatocellular carcinoma after transcatheter hepatic arterial embolization. Cancer 57:1184

    Google Scholar 

  3. Jinno K, Moriwaki S (1988) Intra-arterial infusion therapy with anticancer agents/lipiodol. In: Cancer of the liver: diagnosis and treatment (in Japanese). Kodansha, Tokyo, p 79

    Google Scholar 

  4. Jinno K, Tokuyama K, Yumoto Y, Araki Y, Fujita Y, Ishimitsu T, Fukuda K, Kusumoto G, Moriwaki S, Maeda H, Konno T (1984) Intra-arterial injection of lipophilic anticancer drug (SMANCS/lipiodol) and transcatheter arterial embolization combination therapy in hepatocellular carcinoma (in Japanese). Igaku No Ayumi 128:565

    Google Scholar 

  5. Jinno K, Moriwaki S, Tokuyama K, Yumoto Y, Fukuda K, Maeda H, Konno T (1986) Clinico-pathologic study on selective accumulation of lipiodol, an oily contrast medium, in hepatocellular carcinoma (in Japanese). Acta Hepatol Jpn 27:471

    Google Scholar 

  6. Jinno K, Tokuyama K, Yumoto Y, Wada T, Okamoto T, Kobashi H, Moriwaki S, Tanada M, Maeda H, Konno T (1988) Significance of lipiodol-CT in the evaluation of therapeutic effects of Lp-TAE for hepatocellular carcinoma. Clinicopathologic study (in Japanese). J Jpn Soc Cancer Ther 23:1660

    Google Scholar 

  7. Kanematsu T, Inokuchi K, Sugimachi K, Furuta T, Sonoda T, Tamura S, Hasuo K (1984) Selective effect of lipiodolized antitumor agents. J Surg Oncol 25:218

    Google Scholar 

  8. Kasugai H, Kojima J, Tatsuta M, Okuda S, Sasaki Y, Imaoka S, Fujita M, Ishiguro S (1989) Treatment of hepatocellular carcinoma by transcatheter arterial embolization combined with intraarterial infusion of a mixture of cisplatin and ethiodized oil. Gastroenterology 97:965

    Google Scholar 

  9. Konno T, Maeda H, Iwai K, Tashiro S, Maki S, Morinaga T, Mochinaga M, Hiraoka T, Yokoyama I (1983) Effect of arterial administration of high-molecular weight anti-cancer agent, SMANCS, with lipid lymphographic agent on hepatoma: a preliminary report. Eur J Clin Oncol 19:1053

    Google Scholar 

  10. Livrahgi T, Festi D, Monti F, Salmi A, Vettori C (1986) US-guided percutaneous alcohol injection of small hepatic and abdominal tumors. Radiology 161:309

    Google Scholar 

  11. Maeda H, Takeshita J, Kanemaru R (1979) A lipophilic derivative of neocarzinostatin. Int J Pept Protein Res 14:81

    Google Scholar 

  12. Ryu M, Yamamoto Y, Yamamoto H, Watanabe Y, Nagashima T, Ariga T, Juan IK, Okada M, Sato H (1984) Evaluation of the effect of transcatheter arterial embolization (TAE) as a preoperative therapy for minute hepatocellular carcinomas (in Japanese) Acta Hepatol Jpn 25:881

    Google Scholar 

  13. Shibata J, Fujiyama S, Sato T, Kishimoto S, Fukushima S, Nakano M (1989) Hepatic arterial, injection chemotherapy with cisplatin suspended in an oily lymphographic agent for hepatocellular carcinoma. Cancer 64:1586

    Google Scholar 

  14. Shimamura Y., Gunvén P, Takenaka Y, Shimizu H, Shima Y, Akimoto H, Arima K, Takahashi A, Kitaya T, Matsuyama T, Hasegawa H, (1988) Combined peripheral and central chemoembolization of liver tumors. Experience with lipiodol-doxorubicin and gelatin sponge (L-TAE). Cancer 61:238

    Google Scholar 

  15. Yamada R, Sato M, Kawabata M, Nakatsuka H, Nakamura K, Takashima S (1983) Hepatic arterial embolization in 120 patients with unresectable hepatoma. Radiology 148:397

    Google Scholar 

  16. Yumoto Y, Jinno K, Tokuyama K, Araki Y, Ishimitsu T, Maeda H, Konno T, Iwamoto S, Ohnishi K, Okuda K (1985) Hepatocellular carcinoma detected by iodized oil. Radiology 154:19

    Google Scholar 

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Jinno, K., Moriwaki, S., Tanada, M. et al. Clinicopathological study on combination therapy consisting of arterial infusion of lipiodol-dissolved SMANCS and transcatheter arterial embolization for hepatocellular carcinoma. Cancer Chemother. Pharmacol. 31 (Suppl 1), S7–S12 (1992). https://doi.org/10.1007/BF00687097

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