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Journal of the Korean Liver Cancer Study 2012;12(1):10-13.
Published online February 28, 2012.
Standardization of Conventional Chemoembolization for Hepatocellular Carcinoma
Jin Wook Chung
Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
Correspondence:  Jin Wook Chung,
Email: chungjw@snu.ac.kr
Copyright ©2012 by The Korean Liver Cancer Association
Abstract
In conventional chemoembolization for hepatocellula carcinoma, there are diversities in selecting chemotherapeutic drugs and embolic materials and their delivery techniques. And there is no convincing evidence which one is better than the others. As a result, lack of standarized protocol has been indicated as a limitation of conventional chemoembolization. However, we have to understand that hepatic functional reserve and tumoral factors are more important prognostic factors than technical factors in chemoembolization. In patients with diverse hepatic function and tumoral status, it is practically impossible to apply standardized protocol of chemoembolization. Standardized protocol in chemoembolization may increase the risk of the procedure or decrease the therapeutic efficacy and, as a result, shorten the survival of the patients. Chemoembolization technique should be customized individually depending on hepatic functional reserve and tumoral factors. More importantly, we should keep the basic principle of chemoembolization. The most important basic principle is to perform superselective chemoembolization of all tumor feeders. Cone-beam CT and low-profile microcatheters may greatly help interventional radiologists identify and superselectively catheterize tumor feeders and monitor the completeness of the procedure.
Key Words: Hepatocellular carcinoma; Chemoembolization
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