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KMID : 0352119950110010040
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Journal of Kyung Hee University
1995 Volume.11 No. 1 p.40 ~ p.53
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Transarterial Lipiodol Chemoembolization with Gelfoam for Treatment of Hepatocellular Carcinoma Combined with Main Portal Vein Occlusion
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Abstract
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The purpose of this article is a prospective evaluation of the efficacy and prognostic factors of transarterial lipiodol chemoembolization (LP-TAE) with gelfoam in patients with hepatocellular carcinoma (HCC) who have main portal vein occlusion.
LP-TAE with gelfoam was attempted in 20 patients with HCC combined with main portal vein occlusion between February 1993 and August 1994. The LpTAE was performed by a mixture of lipiodol (6~30 ml) and adriamycin (30~50mg), followed by gelfoam
embolization. Patients were followed up clinically and with radiologic studies. Survival rate was calculated according to the Kaplan and Meier method.
The survival period of the 20 patients ranged from 2 to 52 weeks, with cumulated survival of 75% at 12 weeks and 51% at 24 weeks. Before LP-TAE with gelfoam, 10 patients had not ascites and 10 patients had ascites. The cumulative survival was 79%
at 24
weeks in group without ascites and 19% in group with ascites. There was a significant correlation (p<0.05) between ascites and prognosis. While Child class B group made the prognosis poor, there was no significant difference in prognosis is
between
Child class A group and child class B group (p=0.126). After LP-TAE with gelfoam, impairment of liver function was developed in most patients but improved within 4~12 weeks. Two patients was dead due to acute hepatic failure.
LP-TAE with gelfoam was relatively safe in patients with HCC who have main portal vein occlusion. Consequently, it may be useful treatment modality in selected patients.
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