No abstract

The high rate of recurrence after surgical resection of hepatocellular carcinoma (HCC) is a major therapeutic challenge. Postoperative injection of 131-iodine-labeled lipiodol ( 131 ILip) into the hepatic artery has been proposed as adjuvant treatment (Lau et al.). We analyzed 2 retrospective series of matched patients treated in our unit before and after addition of 131 I-Lip adjuvant therapy to our standard surgical strategy. Thirty-eight patients who had undergone surgical resection of HCC after January 1999 were given adjuvant intra-arterial injection of 131 I-Lip after surgery. These patients were matched with 38 other patients who had undergone surgical resection only between January 1997 and January 1999. The frequency of recurrences, disease-free rates, and overall survival rates were compared. The 2 groups were similar for clinical, biologic, or histologic parameters studied and Cancer Liver Italian Program scores. There were 15 recurrences in the group without adjuvant treatment and 9 in the group with 131 I-Lip adjuvant treatment. The 1-, 2-, and 3-year disease-free survival rates (؎95% confidence interval) were different (P < .02): 94.7% ؎ 3.6%, 83.7% ؎ 6.1%, and 68.4% ؎ 9.7%, respectively, in the 131 I-Lip group versus 73.7% ؎ 7.1%, 54.3% ؎ 8.2%, and 41.5% ؎ 10.5% in the surgery group. The 1-, 2-, and 3-year survival rates (؎95% confidence interval) also were different (P < .02): 94.7% ؎ 3.6%, 91.7% ؎ 4.6%, and 91.7% ؎ 4.6%, respectively, in the 131 I-Lip group versus 94.7% ؎ 3.6%, 71.3% ؎ 7.8%, and 49.9% ؎ 10% in the surgery group. In conclusion, this retrospective analysis supports the promising contribution of postoperative injection of 131 I-Lip after resection of HCC. A randomized study including more patients would be necessary to confirm its contribution to therapeutic management. (HEPATOLOGY 2003;38:1237-1241

Systemic chemotherapy using the ECF regimen gave a poor response and low survival rates. It would appear reasonable to pursue the search for potentially efficacious chemotherapy protocols using other drug combinations.

No abstract

PRONOPALL study confirms the three prognostic profiles defined by the combination of four factors. This PRONOPALL score is a useful decision-making tool in daily practice.