[Treatment of hepatocellular carcinoma by segmental SMANCS Lipiodol-TAE].

Segmental SMANCS Lipiodol TAE (Seg. SMANCS Lp-TAE) using SMANCS was used to treat HCC in 58 patients and was evaluated in comparison with Seg. Lp-TAE using Epirubicin performed in 50 patients with respect to the course of atrophy of the embolized area, recurrence rate and side effects. On serial CT (Lp-CT) performed after TAE, in cases with P type in which the tumor is present in the periphery of the embolized area and showing Type I homogeneous accumulation of Lp within the tumor, the incidence of atrophy in the embolized area including the tumor was high and the recurrence rate was low. Although no significant difference in the recurrence rate was noted between the groups in which SMANCS and EPI were used, there were more cases with marked atrophy and a lower recurrence rate in the former. No difference was found in post-procedural side effects such as fever between the two groups, while hypotension was rarely observed during the procedure in the group in which SMANCS was used and was easily managed with intravenous steroids. The present results suggest that Seg. SMANCS Lp-TAE is an effective local treatment for HCC limited to a subsegment or segment.

Long-term palliative treatment of hepatocellular carcinoma extending into the portal vein and bile duct by chemoembolization and metallic stenting.

We present a patient with hepatocellular carcinoma accompanied by portal vein and bile duct tumor thrombi. The patient was treated with a spiral Z-stent covered by a polyethylene sheet placed in the bile duct, a Wallstent placed in the portal vein, chemoembolization, and external radiation therapy. The patient is alive with patency of both endoprostheses 18 months later.