Mehmet Güli ÇETİNÇAKMAK, Akif ŞİRİKÇİ, Mehmet Akif SARICA, Serdar SÖNMEZIŞIK, M. Metin BAYRAM

Cerrahi tedavi yapılamayan primer karaciğer tümörlerinde transarteriyel kemoembolizasyon tedavisinin sağ kalıma etkisi

Amaç: Bu çalışmanın amacı, Ocak 2002-Aralık 2008 tarihleri arasında karaciğer tümörü tanısı alan ve Transarteryel Kemoembolizasyon (TAKE) tedavisi uygulanan hepatoselüler karsinom (HCC) tanılı hastalarda tümör yanıtı ve tedavinin sağkalıma etkisini araştırmaktır. Gereç ve yöntem: Cerrahi tedavi yapılamayan 33 HCC tanılı olguya 59 defa TAKE tedavisi uygulandı. Hastalara 1-4 defa (ortalama 1.78 kez) lipiodol+epirubicin hidroklorür emülsiyonu ile lipiodol hepatik arter yoluyla selektif olarak verildi. Hastalar 1, 2 ve 4. ayda abdomen bilgisayarlı tomografi (BT) ve serum albumin, bilirubin, protrombin zamanı (PT), a-fetoprotein (AFP) değerleri ile takip edildi. BT’ de kontrastlanan solid tümör varlığı ve kitle çapı artışı durumlarında işlem tekrar edildi. Bulgular: Çalışmamızda HCC hastalarının tedavi öncesi tümör çapının 5 cm’den büyük olması, diffüz tutulum olması, asit olması, serum albumin değerinin 2.8 g/dl’nin altında olması, bilirubin değeri 3 mg/dl’nin üstünde olması, Child-C evresinde olması, Okuda III evresi ve serum AFP değerinin 400 IU/dl üstünde olması ve lipiodolün az tutulumu kötü prognoz göstergesi olarak saptandı. Tümör boyutu 5 cm’nin altında olması, nodüler olması, asitin olmaması, hastanın serum albuminin >3.5 mg/dl ve bilirubinin

The effect of transarterial chemoembolization therapy to survival in unresectable liver tumors

Objectives: The aim of this study was to investigate the effect of Transarterial Chemoembolization (TAKE) on tumor response survival in patients with hepatocellular carcinoma (HCC) between January 2002 and December 2008. Materials and methods: In 33 unresectable HCC patients TACE treatment was administered 59 times. Lipiodol + epirubycin hidrochlorur emulsion and lipiodol were administered to HCC for 1-4 times (mean 1.78) via the hepatic artery, selectively. Patients were examined at 1st, 2nd, and 4th months with abdomen CT, serum albumin, bilirubin, PT, AFP levels. Procedure was repetaed in case of growth in the initial mass size or enhancing solid portion of tumor on the CT images. Results: In our study, tumor size above 5 cm, diffuse involvement, ascites, serum albumin level below 2.8 g/dl, bilirubin level above 3 mg/dl, Child C stage, Okuda III stage, serum AFP level above 400 IU/dl and low lipiodol involvement were considered as poor prognostic factors. Tumor size below 5 cm, nodularity, absence of ascites, serum albumin levels above 3.5 g/dl, bilirubin levels below 1 mg/dl, Child A stage, Okuda I stage and high lipiodol involvement were found as good prognostic factors. Conclusion: In present study, we found that repetitive TACE procedures improved the survival in selected unresectable HCC patients

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