title: Drug-Eluting Beads Loaded With Doxorubicin (DEBDOX) Chemoembolisation Before Liver Transplantation for Hepatocellular Carcinoma: An Imaging/Histologic Correlation Study.
abstract: OBJECTIVE
  Most transplant centers use chemoembolisation as locoregional bridge therapy for hepatocellular carcinoma (HCC) before liver transplantation (LT). Chemoembolisation using beads loaded with doxorubicin (DEBDOX) is a promising technique that enables delivery of a large quantity of drugs against HCC. We sought to assess the imaging-histologic correlation after DEBDOX chemoembolisation.
  
  
  METHODS
  All consecutive patients who had undergone DEBDOX chemoembolisation before receiving liver graft for HCC were included. Tumour response was evaluated according to Response Evaluation Criteria in Solid Tumours (RECIST) and modified RECIST (mRECIST) criteria. The result of final imaging made before LT was correlated with histological data to predict tumour necrosis.
  
  
  RESULTS
  Twenty-eight patients underwent 43 DEBDOX procedures for 45 HCC. Therapy had a significant effect as shown by a decrease in the mean size of the largest nodule (p = 0.02) and the sum of viable part of tumour sizes according to mRECIST criteria (p < 0.001). An objective response using mRECIST criteria was significantly correlated with mean tumour necrosis ≥90 % (p = 0.03). A complete response using mRECIST criteria enabled accurate prediction of complete tumour necrosis (p = 0.01). Correlations using RECIST criteria were not significant.
  
  
  CONCLUSIONS
  Our data confirm the potential benefit of DEBDOX chemoembolisation as bridge therapy before LT, and they provide a rational basis for new studies focusing on recurrence-free survival after LT. Radiologic evaluation according to mRECIST criteria enables accurate prediction of tumour necrosis, whereas RECIST criteria do not.
authors.affiliation: Department of Digestive Diagnostic and Interventional Radiology, CHRU Lille, Hôpital Claude Huriez, rue Michel Polonoski, 59037, Lille Cedex, France, xpauwels@hotmail.com.
authors.forename: Xavier
authors.initials: X
authors.lastname: Pauwels
authors.forename: Mustapha
authors.initials: M
authors.lastname: Azahaf
authors.forename: Guillaume
authors.initials: G
authors.lastname: Lassailly
authors.forename: Géraldine
authors.initials: G
authors.lastname: Sergent
authors.forename: David
authors.initials: D
authors.lastname: Buob
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Truant
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Boleslawski
authors.forename: Alexandre
authors.initials: A
authors.lastname: Louvet
authors.forename: Vivianne
authors.initials: V
authors.lastname: Gnemmi
authors.forename: Valérie
authors.initials: V
authors.lastname: Canva
authors.forename: Philippe
authors.initials: P
authors.lastname: Mathurin
authors.forename: François-René
authors.initials: FR
authors.lastname: Pruvot
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Leteurtre
authors.forename: Olivier
authors.initials: O
authors.lastname: Ernst
authors.forename: Sébastien
authors.initials: S
authors.lastname: Dharancy
mesh_terms: D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000628:therapy* / Q000648:ultrastructure; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D004317:Doxorubicin / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000648:ultrastructure; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy* / Q000648:ultrastructure; D016031:Liver Transplantation; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D004317:Doxorubicin