摘要
AIM: To evaluate the downstaging rates in hepatitis C virus-patients with hepatocellular carcinoma(HCC), treated with degradable starch microspheres transcatheter arterial chemoembolization(DSM-TACE), to reach new-Milan-criteria(nM C) for transplantation. METHODS: This study was approved by the Ethics Committee of our institution. From September 2013 to March 2014 eight patients(5 men and 3 women) with liver cirrhosis and multinodular HCC, that did not meet n MC at baseline, were enrolled in this study. Patients who received any other type of treatment such as termal ablation or percutaneous ethanol injection were excluded. DSM-TACE was performed in all patients using Embo Cept? S and doxorubicin. Baseline and follow-up computed tomography or magnetic resonance imaging was assessed measuring the longest enhancing axial dimension of each tumor according to the modified Response Evaluation Criteria In Solid Tumors measure-ments, and medical records were reviewed.RESULTS: DSM-TACE was successfully performed in all patients without major complication. We treated 35 lesions(mean 4.3 per patient). Six of eight patients(75%) had their HCC downstaged to meet nM C. Every patient whose disease was downstaged eventually underwent transplantation. The six patients who received transplant were still living at the time of this writing, without recurrence of HCC. Baseline age(P = 0.25), Model for End-stage Liver Disease score(P = 0. 77), and α-fetoprotein level(P = 1.00) were similar between patients with and without downstaged HCC. CONCLUSION: DSM-TACE represents a safely and effective treatment option with similar safety and efficacy of conventional chemoembolization and could be successfully performed also for downstaging disease in patients without n MC, allowing them to reach liver transplantation.
AIM To evaluate the downstaging rates in hepatitisC virus-patients with hepatocellular carcinoma （HCC）,treated with degradable starch microspheres transcatheterarterial chemoembolization （DSM-TACE）, toreach new-Milan-criteria （nMC） for transplantation.METHODS： This study was approved by the EthicsCommittee of our institution. From September 2013 toMarch 2014 eight patients （5 men and 3 women） withliver cirrhosis and multinodular HCC, that did not meetnMC at baseline, were enrolled in this study. Patientswho received any other type of treatment such astermal ablation or percutaneous ethanol injection wereexcluded. DSM-TACE was performed in all patientsusing EmboCept- S and doxorubicin. Baseline andfollow-up computed tomography or magnetic resonanceimaging was assessed measuring the longest enhancingaxial dimension of each tumor according to the modifiedResponse Evaluation Criteria In Solid Tumors measure ments, and medical records were reviewed.RESULTS： DSM-TACE was successfully performed inall patients without major complication. We treated 35lesions （mean 4.3 per patient）. Six of eight patients（75%） had their HCC downstaged to meet nMC. Everypatient whose disease was downstaged eventuallyunderwent transplantation. The six patients who receivedtransplant were still living at the time of thiswriting, without recurrence of HCC. Baseline age （P =0.25）, Model for End-stage Liver Disease score （P =0. 77）, and α-fetoprotein level （P = 1.00） were similarbetween patients with and without downstaged HCC.CONCLUSION： DSM-TACE represents a safely andeffective treatment option with similar safety andefficacy of conventional chemoembolization and couldbe successfully performed also for downstaging diseasein patients without nMC, allowing them to reach livertransplantation.
