Quality of Life and Long-Term Results of Percutaneous Isolated Hepatic Perfusion for Stage IV Hepatocellular Carcinoma

Yonson Ku, Masahiro Tominaga, Takeshi Iwasaki, Takumi Fukumoto, Sanshiro Muramatsu, Nobuya Kusunoki, Shinobu Tsuchida, Manabu Takamatsu, Yasuyuki Suzuki and Yoshikazu Kuroda

First Department of Surgery, Faculty of Medicine, Kobe University

The aim of this study was to determine quality of life (QOL), predictive factors of tumor response, and long-term outcome in 36 patients with Stage IV hepatocellular carcinoma (HCC) treated by percutaneous isolated hepatic perfusion (PIHP). Thirsy-one patients had Stage IV_A and the remaining 5 had IV_B disease. Seventeen patients were HBs-Ag positive, while 15 others were HCV-Ab positive. Excluding one nonevaluable patient, the overall response rate reached 60%: 6 CR and 15 PR. When responders (CR+PR) and nonresponders (SD+PD) were compared, no factors predictive of a tumor response were identified. However, when modes of tumor response were compared, a distinct type of response (CR+PD) was more frequently seen in HBs-Ag positive patients, whereas an intermediate type of response (PR+SD) was predominant in HCV-Ab positive patients. The 5-year actuarial survival rate was 32% in all 36 patients. Long-term survivals in patients with Stage IV_A vs IV_B and V_P (-) vs V_P (+) disease were 36% vs 0% and 47% vs 23%, respectively, at 5 years. Except for 2 early patients with fatal complications, QOL was excellent in all patients. These results indicate that PIHP is a minimally invasive surgery, and the first-line treatment for patients with Stage IV_A hepatocellular carcinoma.

Key words
advanced hepatocellular carcinoma, parcutaneous isolated hepatic perfusion, long-term prognosis

Reprint requests
Yonson Ku First Department of Surgery, Kobe University 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017 JAPAN

Accepted
January 27, 1999

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