INTERVENČNÍ METODY V LÉČBĚ MALIGNÍCHPROCESŮ JATER

Interventional Methods in the Treatment of Malignant Tumors of the Liver

The article overviews vascular and percutaneous interventional methods used in the locoregional chemotherapyof liver tumors. It is based on experience from the treatment of 248 patients on the Radiodiagnostic clinic of theTeaching hospital in Brno (Bohunice department). Chemoembolization includes precisely aimed administration ofcytostatics and a total ischaemization of the malignant tissue. Another method of locoregional chemotherapy is theadministration of high doses of cytostatics into the afferent artery. Positive effect can be achieved only when thecytostatic perfuses all liver segments. Preoperative embolization of the portal vein represents an effective preliminarytreatment of patients before the liver ablation. Percutaneous thermal ablation and the use of percutaneous ethanolinjections are limited by the costs of treatment, by the number, size and location of tumors. Percutaneous ethanolinjections are indicated in the treatment of hepatocellular carcinoma in the cirrhotic tissue. Percutaneous thermalablation can effectively destroy foci in the liver up to the size of 5 cm without impairment of the surrounding tissue.Locoregional and percutaneous therapy of malignant liver processes represent alternative methods and individualapproaches should be combined. Indication has to be carefully thought about by an interdisciplinary committee. Itis necessary to realise that the aim is not to perform „technically precise operation“ gut the lengths and quality ofthe patient’s life.

Key words:
liver tumor, chemoembolization, embolization, locoregional chemotherapy, thermal ablation, ethanolinjections.