TL;DR: Liver transplantation is an effective treatment for small, unresectable hepatocellular carcinomas in patients with cirrhosis and after four years, the actuarial survival rate was 75 percent and the rate of recurrence-free survival was 83 percent.
Abstract: Background The role of orthotopic liver transplantation in the treatment of patients with cirrhosis and hepatocellular carcinoma is controversial, and determining which patients are likely to have a good outcome after liver transplantation is difficult. Methods We studied 48 patients with cirrhosis who had small, unresectable hepatocellular carcinomas and who underwent liver transplantation. In 94 percent of the patients, the cirrhosis was related to infection with hepatitis B virus, hepatitis C virus, or both. The presence of tumor was confirmed by biopsy or serum alpha-fetoprotein assay. The criteria for eligibility for transplantation were the presence of a tumor 5 cm or less in diameter in patients with single hepatocellular carcinomas and no more than three tumor nodules, each 3 cm or less in diameter, in patients with multiple tumors. Twenty-eight patients with sufficient hepatic function underwent treatment for the tumor, mainly chemoembolization, before transplantation. After liver transplantation...
TL;DR: Chemoembolisation improved survival of stringently selected patients with unresectable hepatocellular carcinoma and was associated with a significantly lower rate of portal-vein invasion than conservative treatment.
TL;DR: In Asian patients with unresectable hepatocellular carcinoma, transarterial Lipiodol chemoembolization significantly improves survival and is an effective form of treatment.
TL;DR: Clinical outcomes of patients treated with intra-arterial yttrium-90 microspheres (Y90) can be used to design future Y90 trials and to describe Y90 as a potential treatment option for patients with HCC.
TL;DR: The study was stopped in December 1992, after a sequential analysis showed the lack of the expected benefit from chemoembolization.
Abstract: Background Chemoembolization with Lipiodol (iodized oil) is widely used to treat patients with unresectable hepatocellular carcinoma. Severe side effects have been reported, and improved survival has not been clearly demonstrated. Methods Patients with unresectable hepatocellular carcinoma who did not have severe liver disease and who met additional entry criteria were randomly assigned to receive either Lipiodol chemoembolization (70 mg of cisplatin, 10 ml of Lipiodol, and gelatin-sponge [Gelfoam] particles delivered through the hepatic artery) or conservative management involving treatment of complications and pain. Courses of treatment were to be given every two months for a maximum of four courses. The main end point was survival. Results The study was stopped in December 1992, after a sequential analysis showed the lack of the expected benefit from chemoembolization. As of October 1, 1994, 39 of the 50 patients assigned to chemoembolization and 40 of the 46 patients assigned to conservative managemen...