Lipiodolization prolongs survival rates in postoperative patients with a recurrent hepatocellular carcinoma.

Curative resections were performed in 200 patients with primary hepatocellular carcinoma (HCC) during the period from 1971 to 1988, at Kyushu University Hospital. Patients seen before 1982 numbered 73 (group I), and the remaining 127 underwent hepatic resection after 1983 (group II). Thirty-nine (53.4%) of the 73 patients in group I had a recurrence during the follow-up period, as did 61 (48.0%) in group II. HCC resections done after 1983 (group II) were associated with (1) a low incidence of operative deaths (I 15.1% vs. II 2.4%) and hospital deaths (I 30.1% vs. II 5.5%), (2) relatively well-preserved hepatocellular function (indocyanine green test, I 24.5 +/- 12.6% vs. II 17.4 +/- 9.2%), (3) a low incidence of histologically verified concomitant cirrhosis (I 87.7% vs. II 68.5%) (4), and smaller HCC nodules (I 6.4 +/- 4.4 cm vs. II 4.1 +/- 3.1 cm). The survival rates of patients seen after 1983 were significantly better than those of patients resected prior to 1982. With respect of the recurrence-free rates achieved by curative hepatic resection, there was no statistically significant difference to be seen between the two groups. In the case of patients submitted of lipiodolization treatment for a recurrent HCC, the survival rates were better than in patients on systemic chemotherapy. Since lipiodolization prolongs survival time after a recurrence of HCC, this form of treatment should be given due consideration.