Gut Liver.  2009 Dec;3(4):285-291.

Prediction of Complete Necrosis of Hepatocellular Carcinoma Treated with Transarterial Chemoembolization Prior to Liver Transplantation

• Kim SJ
• Choi MS
• Kang JY
• Choi DI
• Park CK
• Gwak GY
• Lee JH
• Koh KC
• Paik SW
• Yoo BC

Abstract

BACKGROUND/AIMS
Compact lipiodol uptake without enhancement on multiphasic helical computed tomography (CT) has been suggested as a radiologic response criterion in hepatocellular carcinoma (HCC) patients treated with transarterial chemoembolization (TACE) and subsequent partial hepatectomy. However, its usefulness has not been fully investigated in the explanted liver. METHODS: Between 1998 and 2007, 81 patients with HCC underwent 1-9 sessions of TACE followed by liver transplantation (LT). Thirty-nine tumors in 29 patients showed a radiologic response on CT performed prior to LT. The radiologic response criteria and the duration of the response were evaluated to predict total necrosis in the explanted liver. RESULTS: Among the 39 tumors, 34 nodules (87.2%) exhibited total pathological necrosis. While 13 out of 16 tumors (81.3%) with a radiologic response for 6 months or less were completely necrotic, 21 out of 23 tumors (91.3%) with a radiologic response of longer than 6 months showed total necrosis. CONCLUSIONS: Our results suggested that the radiologic response criteria based on serial CT images might be useful for predicting total necrosis of TACE-pretreated HCC in LT.

Keyword

Explanted liver; Pathology; Computed tomography; Radiologic response

MeSH Terms

Carcinoma, Hepatocellular
Ethiodized Oil
Hepatectomy
Humans
Liver
Liver Transplantation
Necrosis
Tomography, Spiral Computed
Ethiodized Oil