Efficacy of loco-regional ablation therapy of HCC in a population of liver transplanted patients.
OBJECTIVE
Loco-ablation therapy (LAT) has become standard treatment for patients with HCC who are candidates for liver transplantation (LT). The aim of this study was: to evaluate if LAT was able to induce complete necrosis of tumour mass; to determine the tumour recurrence rate after LT and factors associated with recurrence.


METHODS
The percentage and the distribution of necrosis in 116 HCC nodules of 61 patients with (26 patients) and without (35 patients) previous types of LAT were examined in explanted livers.


RESULTS
Total necrosis was found only in 7% of treated nodules, and 42% of these showed absence of necrosis. The amount of necrosis was significantly related to the gross appearance of HCC: a single nodule with smaller adjacent satellite nodules showed a higher percentage of necrosis. No relation was found between the amount of necrosis and the type of LAT. Recurrence was observed in 11.5% and 8.5% of patients with and without previous LAT, respectively (P = ns).


CONCLUSIONS
LAT very rarely induces complete necrosis; the amount of necrosis seems to depend on the growth pattern of the tumour and not on the type of previous LAT; the tumour size, measured at explant, is the only variable significantly related to recurrence.
Morisco
Filomena
F
Liver Transplant and Hepatobiliary Medicine, Royal Free Hospital, London, UK. filomena.morisco@unina.it
Stigliano
Rosa
R
Godfrey
Andrew
A
Leandro
Gioacchino
G
Patch
David
D
Davidson
Brian
B
Rolles
Keith
K
Dhillon
Arjun
A
Dhillon
Amar Paul
AP
Quaglia
Alberto
A
Burroughs
Andrew Kenneth
AK
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D004564:Electrocoagulation; D000431:Ethanol / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000628:therapy*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D012997:Solvents / Q000627:therapeutic use; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D012997:Solvents; D000431:Ethanol