Efficacy of selective transarterial chemoembolization in inducing tumor necrosis in small (<5 cm) hepatocellular carcinomas.

摘要: Transarterial chemoembolization (TACE) is commonly used as a bridge therapy for patients awaiting liver transplantation (LT) and downstaging initially not meeting the Milan criteria. The primary aim of this study was to analyze whether difference exists between selective/superselective lobar TACE in determining tumor necrosis by pathological analysis whole lesion at time LT. secondary investigate relationship size capacity induce necrosis. Data were extracted from prospective database 67 consecutive who underwent LT hepatocellular carcinoma cirrhosis 2003 2009 treated exclusively with bridging (n = 53) or 14). We identified 122 nodules; 53.3% TACE. mean histological level 64.7%; complete obtained 42.6% nodules. In comparison TACE, led significantly higher levels (75.1% versus 52.8%, P 0.002) rate (53.8% 29.8%, 0.013). A significant direct observed diameter (59.6% lesions 3 cm). Histological maximal tumors > cm: 91.8% after 66.5% procedures. Independent predictors (P 0.049) treatment single nodules 0.008). Repeat sessions more frequently needed (31.6% 59.3%, 0.049). Conclusion: Selective/superselective successful than procedures achieving necrosis, effective 3- 5-cm smaller ones. (Hepatology 2011;)