Objective To investigate the efficacy and safety of transcatheter arterial chemoembolization (TACE)in combination with secondary resection in the treatment of massive extrahepatic growing hepatocellular carcinoma(E-HCC).

Methods Five patients were involved in this study.CT reviewed after the first time of TACE treatment a month.If the lesion was not filled with satisfaction by chemotherapic agents lipiodol emulsion, arterial angiography and TACE were performed again.If failed to inject chemotherapic agents lipiodol emulsion into the lesions through the feeding arteries, the secondary resection was used.

Results Five patients underwent TACE treatment 9 times, an average of 1.8 times.CT reviewed the iodized oil deposition in the tumor showed 3 types after all patient were treated first time of TACE a month: completely filled 1 case; dense filled 3 cases; spot or ring-type filled 1 case.After received the secondary resection, 3 cases of them were underwent curative resection successfully, the other 2 cases were used palliative resection due to surrounding tissue severe adhesion. Post-operative pathological specimen showed 35%~100% tumor necrosis (average 74.8%). During a follow-up of 13~27 months, 1 survived and 4 deaths, the median survival time was 22.2 months. No severe complications were observed.

Conclusion TACE can induce obvious necrosis and shrinkage of E-HCC and increase the opportunities of secondary resection.