摘要AIM: To prospectively evaluate the short andlong term clinical impact of selective transarterialchemoembolization (TACE) on liver function in patientswith hepatocellular carcinoma (HCC). To assess sideeffects in relation to treatments. To analyze the overallsurvival and HCC progression free survival probability.METHODS: One hundred and seventeen cirrhoticpatients with HCC were enrolled. Baseline liver functionincluded Child-Pugh score and serum levels of alanineaminotransferase(ALT), prothrombin time (PT) and bilirubin. According to Cancer Liver Italian Program(CLIP) and Barcelona Clinic Liver Cancer (BCLC)staging systems, 71 patients were eligible for TACE;32 had previously received treatment for HCC. Nosignificant differences in liver function were observedbetween previously treated and not treated patients.TACE was performed by selective catheterization ofthe arteries nourishing the lesions. While hospitalized,pat ients underwent cl inical , hematologic andultrasonographic assessments. One month after TACEa CT scan was performed to assess tumor response.A second TACE was performed ?°on demand?±. Liverfunction tests were checked in all patients every fourmonths. RESULTS: After first TACE, the mean Child-Pugh scoreincreased from a mean baseline 5.62 ?à 1.12 to 6.11 ?à 1.57at discharge time ( P < 0.0001), decreasing after fourmonths to 5.81 ± 0.73 (not significant). ALT, PT andbilirubin significantly ( P < 0.0001) increased 24 h afterTACE and progressively decreased until discharge.After the second TACE, variations in Child-Pughscore, ALT, PT and bilirubin were comparable to thatdescribed after the first TACE. No major complicationswere observed. The mean follow-up was 14.7 ?à 6.3 mo(median: 16 mo). Only one patient died. No otherpatient experienced important long term worseningof clinical status. The overall survival probability attwenty-four months was 98.18% with a correspondentHCC progression free survival probability of 69%.CONCLUSION: Selec t ive TACE may producesignificant, but transitory increases in ALT values,with no major impact on liver function and Child-Pughscore. Preservation of liver function is achievable alsoin patients previously treated with other therapeuticmodalities and in patients undergoing multiple TACEcycles. Liver function can remain stable in the long-term,with optimal medium term survival. This result can beachieved through rigorous patient selection on the basisof tumour characteristics and clinical conditions.