title: Histologic study of the effects of chemoembolization with preloaded doxorubicin beads in patients with hepatocellular carcinoma.
abstract: OBJECTIVE
  To determine the degree of tumor necrosis in surgical specimens of hepatocellular carcinomas treated with microspheres preloaded with doxorubicin and to analyze the relationship between the degree of necrosis and a) morphologic factors and b) imaging biomarkers.
  
  
  METHODS
  We studied the livers of 21 patients who had undergone selective arterial chemoembolization with DC beads (Biocompatibles, UK) before receiving liver transplants.
  
  
  RESULTS
  Imaging techniques detected 43 nodules (mean size, 25 mm). Angiography showed 25 hypervascularized nodules, 12 slightly vascularized nodules, and 6 avascular nodules. A total of 81 hepatocellular carcinomas (mean size, 15 mm) were detected in the specimens: two were capsular and two had vascular infiltration. The mean degree of necrosis after chemoembolization was 39%; necrosis was greater than 60% in 28 hepatocellular carcinomas and less than 60% in 52. The degree of necrosis correlated significantly with the time elapsed between the last chemoembolization treatment and liver transplantation (the degree of necrosis decreased as time increased), with the number of nodules in the specimen, and with capsular infiltration. When imaging techniques detected 1 or 2 nodules, there was a greater probability of achieving greater than 90% necrosis. No relation with the degree of necrosis achieved was found for the size of the nodules detected at imaging, the enhancement pattern, or the number of chemoembolization treatments.
  
  
  CONCLUSIONS
  The degree of necrosis achieved depends on the time spent on the waiting list, on the number of nodules in the specimen, and on whether capsular infiltration is present.
authors.affiliation: Unidad de Radiología Intervencionista, Hospital Universitario Reina Sofía, Córdoba, España. Electronic address: lzurera61@gamil.com.
authors.forename: L J
authors.initials: LJ
authors.lastname: Zurera
authors.affiliation: Unidad de Radiología Intervencionista, Hospital Universitario Reina Sofía, Córdoba, España.
authors.forename: J J
authors.initials: JJ
authors.lastname: Espejo
authors.affiliation: Unidad de Radiología Intervencionista, Hospital Universitario Reina Sofía, Córdoba, España.
authors.forename: S
authors.initials: S
authors.lastname: Lombardo
authors.affiliation: Departamento de Anatomía Patológica, Hospital Universitario Reina Sofía, Córdoba, España.
authors.forename: T
authors.initials: T
authors.lastname: Marchal
authors.affiliation: IMIBIC, Hospital Universitario Reina Sofía, Córdoba, España.
authors.forename: M C
authors.initials: MC
authors.lastname: Muñoz
authors.affiliation: Unidad de Radiología Intervencionista, Hospital Universitario Reina Sofía, Córdoba, España.
authors.forename: M
authors.initials: M
authors.lastname: Canis
authors.affiliation: Unidad de Hepatología, Hospital Universitario Reina Sofía, Córdoba, España.
authors.forename: J L
authors.initials: JL
authors.lastname: Montero
mesh_terms: D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000601:surgery / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D004317:Doxorubicin / Q000008:administration & dosage*; D004337:Drug Carriers; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery / Q000628:therapy*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D000903:Antibiotics, Antineoplastic; D004337:Drug Carriers; D004317:Doxorubicin
keywords: Anatomic pathology; Anatomía patológica; Carcinoma hepatocelular; Chemoembolization; Hepatocellular carcinoma; Liver transplant; Quimioembolización; Trasplante hepático