Effects of transarterial chemoembolization on the hepatic functional reserve for hepatocellular carcinoma with intratumoral portosystemic shunts

The aim of this study was to evaluate the effects of preoperative transarterial chemoembolization (TACE) prior to microwave coagulation therapy (MCT) for hepatocellular carcinoma (HCC) with intratumoral portosystemic shunts. ICG R15 and 99mTc-GSA (LHL 15, functional liver volume) evaluated before and two or three weeks after TACE in 11 HCC patients with portosystemic shunts (shunt (+) group), and in 21 HCC patients without portosystemic shunts (shunt (-) group). Levels of ICG R15 after TACE significantly decreased in shunt (+) group. LHL 15 in shunt (+) group tended to increase after TACE. Although the functional liver volume in shunt (-) group decreased significantly following TACE, no significant change found in shunt (+) group. No major complications occurred in both groups and no significant differences were recognized in survival between the two groups. In conclusion, these results indicate that TACE prior to MCT is useful for increments of effective hepatic blood flow in HCC patients with intratumoral portosystemic shunts, without deterioration of the functional liver volume. (author)