title: Changes in staging for hepatocellular carcinoma after radiofrequency ablation prior to liver transplantation as found in the explanted liver.
abstract: OBJECTIVE
  To analyze the efficacy of radiofrequency ablation (RFA) prior to liver transplantation (LT) in liver explants.
  
  
  METHODS
  We reviewed pathological findings in the explanted livers of 13 patients with histologically proven HCC and liver cirrhosis who underwent RFA as bridging treatment prior to LT. Eight patients had solitary nodules with a median diameter of 4cm, whereas five patients had two tumors each with a median total diameter of 3.3cm prior to RFA. One session of RFA was performed by all patients.
  
  
  RESULTS
  Tumor regression was proved in 3/13 patients whereas steady disease was observed in 5/13 patients (38%). Tumor regression was observed only in one of the five patients having two tumors prior to RFA. Pathology proved a multifocal tumor in four patients, including one patient with a radiological presumed solitary tumor. Tumor progression was observed in 5/13 patients (38%).
  
  
  CONCLUSIONS
  Although the majority of our patients (8/13, 62%) had a solitary tumor at the beginning of treatment, tumor progression was observed in a large proportion (38%) among them. The underestimation of tumor lesions in radiology and partial necrosis of the tumor achieved in most patients limit the role of RFA as bridging treatment prior to LT.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Essen, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Schroeder
authors.forename: Georgios C
authors.initials: GC
authors.lastname: Sotiropoulos
authors.forename: Ernesto P
authors.initials: EP
authors.lastname: Molmenti
authors.forename: Hilmar
authors.initials: H
authors.lastname: Kuehl
authors.forename: Vito R
authors.initials: VR
authors.lastname: Cicinnati
authors.forename: Klaus J
authors.initials: KJ
authors.lastname: Schmitz
authors.forename: László
authors.initials: L
authors.lastname: Kóbori
authors.forename: Andreas
authors.initials: A
authors.lastname: Paul
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Mathé
mesh_terms: D017115:Catheter Ablation; D018450:Disease Progression; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery*; D016031:Liver Transplantation; D009367:Neoplasm Staging