Non-resective ablation and liver transplantation in patients with cirrhosis and hepatocellular carcinoma (HCC): Safety and efficacy
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Maluf, D
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Virginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USAVirginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USA
Maluf, D
[1
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Fisher, RA
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Virginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USAVirginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USA
Fisher, RA
[1
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Maroney, T
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Virginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USAVirginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USA
Maroney, T
[1
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Cotterell, A
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Virginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USAVirginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USA
Cotterell, A
[1
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Fulcher, A
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Virginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USAVirginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USA
Fulcher, A
[1
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Tisnado, J
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Virginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USAVirginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USA
Tisnado, J
[1
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Contos, M
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Virginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USAVirginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USA
Contos, M
[1
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Luketic, V
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Virginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USAVirginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USA
Luketic, V
[1
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Stravitz, R
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Virginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USAVirginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USA
Stravitz, R
[1
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Shiffman, M
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Virginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USAVirginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USA
Shiffman, M
[1
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Sterling, R
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Virginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USAVirginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USA
Sterling, R
[1
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Posner, M
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Virginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USAVirginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USA
Posner, M
[1
]
机构:
[1] Virginia Commonwealth Univ, Med Coll Virginia, Dept Radiol, Div Hepatol,Div Transplant Surg, Richmond, VA 23298 USA
We investigated the efficacy of nonresective ablation techniques and the tumor-free survival of cirrhotic patients undergoing liver transplantation for hepatocellular carcinoma (HCC). In group 1, 11 HCC patients were treated with these techniques and transplanted. On the waiting list, patients were treated to complete ablation, judged by gadolinium-enhanced MRI and alpha-fetoprotein (AFP) levels. Group 1 was compared with a concurrent group of 10 liver transplant patients (group 2) with incidental HCC (stages T1 =three patients, T2 = seven patients). The group 1 patients received 36 procedures (4 alcohol ablations, 14 trans-hepatic artery chemo-embolizations, 15 trans-hepatic chemo-infusions, and 3 radio frequency ablations) for treatment of 13 liver masses. Tumor-node-metastasis (TNM) stage was reduced in eight patients (72.7%), unchanged in two patients and increased in one patient before transplantation. The mean waiting time for transplantation was 12.9 +/- 7.6 months. Both groups had a tumor-free survival of 100%, at 30 +/- 12 months post transplant. On pathology, 54.5% of explanted livers had residual viable HCC after tumor treatment, and 36.4% (4/11) explants had synchronous lesions. Non-resective ablation therapy is safe and effective in reducing the HCC progression in cirrhotic patients awaiting liver transplantation. The cancer-free survival rate in this treatment group is equal to that for incidental T1-T2 HCCs.
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页码:312 / 317
页数:6
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