Excellent outcomes with angiographic subsegmentectomy in the treatment of typical hepatocellular carcinoma: a retrospective study of local recurrence and long-term survival rates in 120 patients with hepatocellular carcinoma.

Background: The authors successfully adopted an interesting and effective treatment for hepatocellular carcinoma (HCC) referred to as angiographic subsegmentectomy (AS). This treatment involved simultaneous embolization of the peripheral feeding artery and the portal vein. The result was that almost all of the HCC and peripheral liver parenchyma developed complete anatomic necrosis.

Methods: To determine the effectiveness of this method, the authors retrospectively studied the local recurrence rates of 49 solitary HCCs and the long-term survival rates of 120 patients with HCC between 2000 and 2008.

Results: The results indicated that, in 31 small, solitary HCCs (<2.0 cm), the local recurrence rate was only 9.6%; and, in 10 slightly larger HCCs (<3.0 cm), the local recurrence rate was only 10%. The 5-year, 8-year, and 10-year survival rates for patients with stage I and stage I/Child-Pugh grade A HCC were 74.27% and 77.65%, 53.05% and 51.76%, and 53% and 51.76%, respectively; and the 5-year, 8-year, and 10-year survival rates for patients with stage II and stage II/Child-Pugh grade A HCC were 66.21% and 71.41%, 39.9% and 39.60%, and 29.92% and 25%), respectively. There were no severe complications.

Conclusions: AS should be investigated further as potential first-line therapy for the treatment of patients with stage I and II HCC.