The Efficacy of Hepatic Arterial Infusion Therapy for Advanced Hepatocellular Carcinoma according to Extrahepatic Collateral Feeding Vessels

Korean J Hepatol > Volume 11(4); 2005 > Article

The Korean Journal of Hepatology 2005;11(4): 359-370.

The Efficacy of Hepatic Arterial Infusion Therapy for Advanced Hepatocellular Carcinoma according to Extrahepatic Collateral Feeding Vessels

Byoung Kuk Jang, M.D., Woo Jin Chung, M.D., Kyung Sik Park, M.D., Kwang Bum Cho, M.D., Jae Seok Hwang, M.D., Sung Hoon Ahn, M.D., Young Hwan Kim, M.D.1, Jin Soo Choi, M.D.1, and Jung Hyeok Kwon, M.D.1

Department of Internal Medicine and Diagnostic Radiology1, University of Keimyung College of Medicine, Dongsan Medical Center, Daegu, Korea

ABSTRACT

Background/Aims
Despite the poor response rate of 20-30%, hepatic arterial infusion therapy (HAIT) has been often tried for advanced hepatocellular carcinoma with portal vein tumor thrombosis or ineffective response to other treatments. The factors that predict treatment response to HAIT remain unclear. This study ascertained the response rate to HAIT based on the existence of extrahepatic collateral feeding vessels or anatomical variants. Methods: Forty one patients received repeated HAIT using an implanted drug delivery system. Of the 41 patients, 18 patients were treated with 5-FU, epirubicin and mytomycin-C; 17 patients were treated with 5-FU and cisplatin; and 6 patients were treated with 5-FU, cisplatin and leucovorin. The patients were divided into two groups according to the existence of extrahepatic collateral feeding vessels or anatomical variants. Results: Of the 41 patients, 10 patients (24.4%) showed a complete response (CR) or partial response (PR). Of 41 patients, 22 patients (group A) did not have extrahepatic collateral feeding vessel or an anatomical variant, but 19 patients (group B) did. In group A, 10 patients (45.5%) had a treatment response (CR+PR). However, only one patient (5.3%) had a treatment response (CR+PR) in group B. The response rate in group A was significantly higher than that in group B (45.5 vs. 5.3%; P=0.005). The median survival of group A was significantly longer than that of group B (10.8 vs 3.4 months, P=0.031). Conclusions: Hepatic arterial infusion therapy may be useful therapeutic option for patients with advanced HCC, especially in those that do not have extrahepatic collateral feeding vessel or anatomical variant. (Korean J Hepatol 2005;11:359-370)

KeyWords: Hepatocellular carcinoma, Hepatic arterial infusion therapy, Extrahepatic feeding vessel, Anatomical variant