OBJECTIVE: To evaluate the tumor response and patient survival rate following transcatheter arterial chemoembolization (TACE) in recurrent hepatocellular carcinoma (r-HCC) after living donor liver transplantation (LDLT). MATERIALS AND METHODS: Twenty-eight patients with r-HCC underwent one or more cycles of TACE after LDLT (mean, 2.5 cycles). After a mixture of iodized oil and anti-cancer drugs was injected via the arteries feeding the tumors, these vessels were embolized with a gelatin sponge. Tumor response was determined by follow-up CT imaging on all patients four weeks after each TACE procedure. Patient survival was calculated using the Kaplan-Meier survival curve. RESULTS: After TACE, targeted tumor reduced in size by 25% or more in 19 of the 28 study patients (67.9%). However, intrahepatic recurrence or extrahepatic metastasis occurred in 21 of the 28 patients (75.0%) during the 3-month follow-up period and in 26 of the 28 patients (92.9%) during the 6-month period following TACE. Extrahepatic metastasis was noted in 18 of the 28 patients (64.3%). The 1-, 3- and 5-year survival rates following TACE were 47.9, 6.0 and 0%, respectively, with a mean survival of nine months in all patients. There were no significant complications related to TACE. CONCLUSION: TACE produces an effective tumor response for targeted r-HCC after LDLT. However, the survival rate of patients with r-HCC after LDLT is poor due to extrahepatic metastasis and intrahepatic recurrence.
Adult ; Aged ; Antineoplastic Agents/administration & dosage ; Carcinoma, Hepatocellular/blood supply/mortality/*therapy ; *Chemoembolization, Therapeutic ; Cisplatin/administration & dosage ; Contrast Media/administration & dosage ; Female ; Follow-Up Studies ; Humans ; Iodized Oil/administration & dosage ; Liver Neoplasms/blood supply/mortality/*therapy ; Liver Transplantation ; Living Donors ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Recurrence, Local/mortality/*therapy ; Survival Rate