Doxorubicin-eluting bead vs conventional transcatheter arterial chemoembolization for hepatocellular carcinoma before liver transplantation

作     者：Daniele Nicolini Gianluca Svegliati-Baroni Roberto Candelari Cinzia Mincarelli Alessandra Mandolesi Italo Bearzi Federico Mocchegiani Andrea Vecchi Roberto Montalti Antonio Benedetti Andrea Risaliti Marco Vivarelli 

作者机构：Division of Hepatobiliary and Transplant SurgeryDepartment of Gastroenterology and TransplantationPolytechnic University of Marche Division of GastroenterologyDepartment of Gastroenterology and TransplantationPolytechnic University of Marche Division of Interventional RadiologyDepartment of Radiological SciencesPolytechnic University of Marche Division of PathologyDepartment of PathologyPolytechnic University of Marche Division of Hepatobiliary and Transplant SurgeryDepartment of Medical and Biological SciencesUniversityof Udine 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2013年第19卷第34期

页      面：5622-5632页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Liver transplantation Hepatocellular carcinoma Transcatheter arterial chemoembolization Doxorubicin-eluting bead Tumor histology Recurrence-free survival Locoregional therapies 

摘      要：AIM:To assess the possible effect of two different types of preoperative transcatheter arterial chemoembolization(TACE)on recurrence-free survival after liver transplantation(LT)in patients with hepatocellular carcinoma(HCC)and to analyze the effects of TACE on tumor ***:We retrospectively analyzed the histological features of 130 HCC nodules in 63 native livers removed at *** who received any other type of treatment such as radiofrequency tumor ablation,percutaneous ethanol ablation or who were not treated at all were *** patients in the present study were within the Milan Criteria at the last imaging findings before *** bead TACE(DEB-TACE)was performed in 22patients(38 nodules),and conventional TACE(c-TACE)in 16(25 nodules).Patients’and tumors’characteristics were retrospectively *** performed a pernodule analysis of the explanted livers to establish the mean percentage of necrosis of any nodule treated by TACE(conventional or DEB)and a per-patient analysis to establish the percentage of necrosis in the cumulative tumor area,including 21 nodules not reached by *** and fibrotic changes in the tissue surrounding the tumor nodule were analyzed and categorized as poor/absent,moderate and enhanced ***-and multivariate analysis of risk factors for HCC-recurrence were ***:The number and diameter of the nodules,the time spent on the waiting list and the number of treatments were similar in the two groups.A trend towards higher appropriate response rates(necrosis≥90%)was observed in the DEB-TACE group(44.7%vs32.0%,P=0.2834).The mean percentage of necrosis in the cumulative tumor area was 58.8%±36.6%in the DEB-TACE group and 50.2%±38.1%in the c-TACE group(P=0.4856).Fibrotic and inflammatory reactions surrounding the tumor nodule were markedly more common in the DEB-TACE group(P0.0001,for both the parameters).The three-year recurrence-free survival was hig