Nonresectable fibrolamellar hepatocellular carcinoma: outcome of 4 cases treated by intra-arterial chemotherapy
We evaluated the role of locoregional intraarterial treatment in the management of non-resectable fibrolamellar hepatocellular carcinomas (FLHCC) in 4 women. Three patients underwent transcatheter oily chemoembolization (TOCE) (7 courses), and one received intraarterial iodized oil with chemotherapeutic drug after surgical intraarterial catheter placement (1 course). The latter procedure resulted in marked discomfort and was therefore not repeated. The courses were performed in average every 4 months. TOCE was well tolerated and resulted in a decrease in tumor size in 2 patients, which subsequently permitted a safe hepatic resection. In one patient, TOCE provided a stabilization of tumor size. We conclude that TOCE is a valuable therapeutic tool for the management of non-resectable FLHCC, in particular as it may be followed by hepatic resection.