Prognostic Influence of Preoperative Nocardia Rubra Cell Wall Skelton/Lipiodol Immunotherapy for Hepatocellular Carcinoma

Kazuo Watanabe, Takehide Asano*, Munemasa Ryu, Kaoru Sakamoto, Masahiro Yoshida, Yoshihiro Hujita, Ichiro Honda, Satoshi Watanabe, Yoshihiro Kawakami

Division of Surgery, Chiba Cancer Center Hospital
*Second Department of Surgery, Chiba University, School of Medicine

The emergence of a new tumor after surgery for hepatocellular carcinoma may be due to either recurrence of the residual tumor or multicentral tumorigenesis in a cancerprone liver. From this standpoint the effects of preoperative N-cws/Lipiodol immunotherapy via the hepatic artery were evaluated. Patients who underwent curative surgery for hepatocellular carcinoma were entered into this study. They consisted of 11 patients who received no treatment at the initial presentation as the treatment group and 22 patients with various treatments other than immunotherapy as a control group. In the treatment group N-cws/Lipiodol was given via the hepatic artery preoperatively and N-cws was delivered intracutaneously after surgery. In the control group various treatments were given with clinical consideration in each instance. In the treatment group seven of the eight survivals were free of the tumor and the longest survival period was five years and two months after the treatment. emergence of all tumors in this group occurred within one year. In the control group nine of the 12 survivals were free of the tumor and the longest survival period was three years and two months. In four of the 13 patients who developed a tumor after surgery the tumor appeared two years or longer after surgery. In the treatment group no tumor developed two years or later postoperatively and therefore the four-years- or -longer survival rate improved significantly. The suggested mechanism is that activation of tumor immunity via this immunotherapy suppresses new tumorigenesis in the cancer-prone liver.

Key words
nocardia rubra cell wall skelton, hepatocellular carcinoma, preoperative immunotherapy, recurrence of residual liver tumor, multicentral tumorigenesis

Reprint requests
Kazuo Watanabe Division Digestive Surgery, Chiba Cancer Center Hospital
666-2 Nitona, Chiba, 280 JAPAN

Accepted
March 13, 1991

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