Treatment with Subsegmental Transcatheter Arterial Embolization for Hepatocellular Carcinoma: Prognosis, Recurrence, and Effect on Liver Function

Forty-three patients with hepatocellular carcinomas (HCCs) who had undergone subsegmental transcatheter arterial embolization (sTAE) as initial treatment were studied retrospectively to evaluate the prognosis, recurrence, and effect of sTAE on liver function. Frequent recurrences were observed (disease-free survival rates were 51.2% at 1 year and 7.7% at 3 years), and in the recurrent nodules, 66.4% were distant recurrences. No significant difference was observed in the periods of distant recurrence compared with local recurrence, and also in the periods of distant recurrence with and without local recurrence, implying that strict control of the primary lesion did not prevent distant recurrence. Concerning the effect of sTAE on liver function, ALT and LDH were significantly elevated and albumin was significantly reduced after sTAE (p = 0.002, > 0.0001, and = 0.0009, respectively). But 4 weeks after sTAE, all these levels recovered to their previous values. Moreover transient hepatic reserve reduction after sTAE did not affect the prognosis. In conclusion, for HCCs with such levels of recurrence, strict follow-up and repeat treatments with minimum damage to the hepatic reserve are essential. sTAE is an appropriate and reasonable treatment for such HCCs because of low levels of damage to the hepatic reserve and the possibility of repeat operations. Using sTAE as the main treatment against HCC, survival rates of more than 70% at 3 years were achieved.