title: Chemoembolization of hepatocellular carcinoma in patients who undergo liver transplantation.
abstract: OBJECTIVE
  To determine the efficacy of chemoembolization (CHE) for hepatocellular carcinoma (HCC) in patients with a cirrhotic liver.
  
  
  METHODS
  Twenty-one patients with cirrhosis and 33 HCC nodules received a mean of 2.4 cycles of CHE before orthotopic liver transplantation (OLT). Iodized oil plus doxorubicin (13 patients) or mitoxantrone (eight patients) was injected into the hepatic artery. Twelve (57%) of the patients underwent terminal embolization with gelatin sponge pledgets. After OLT, the percentage of tumor necrosis was assessed in each HCC nodule.
  
  
  RESULTS
  Twelve (36%) of 33 HCC nodules responded completely to CHE (necrosis > 90%). Successful treatment was statistically significantly related to nodular diameter greater than 2 cm (P = .03), solitariness (P = .0009), hypervascularity (P = .001), and good retention of iodized oil (P = .05). Seven (33%) of the patients had major complications; no death occurred in association with CHE. All patients survived OLT; in three patients (14%), HCC recurred a median of 21 months after OLT.
  
  
  CONCLUSIONS
  CHE seems to be an effective treatment for HCC in patients with liver cirrhosis who await OLT.
authors.affiliation: Department of Radiology, National Cancer Institute of Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Spreafico
authors.forename: A
authors.initials: A
authors.lastname: Marchianò
authors.forename: E
authors.initials: E
authors.lastname: Regalia
authors.forename: L F
authors.initials: LF
authors.lastname: Frigerio
authors.forename: F
authors.initials: F
authors.lastname: Garbagnati
authors.forename: S
authors.initials: S
authors.lastname: Andreola
authors.forename: M
authors.initials: M
authors.lastname: Milella
authors.forename: R
authors.initials: R
authors.lastname: Lanocita
authors.forename: V
authors.initials: V
authors.lastname: Mazzaferro
mesh_terms: D015901:Angiography, Digital Subtraction; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D003131:Combined Modality Therapy; D006801:Humans; D008099:Liver / Q000098:blood supply; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D016031:Liver Transplantation; D008875:Middle Aged; D015641:Radiography, Interventional