Role of transarterial chemoembolization [tace] in down staging of hepatocellular carcinoma [hcc] before liver transplantation

Background: liver transplantation [LT] has emerged as the optimal treatment for cirrhotic patients with Hepatocellular carcinoma [HCC] because it cures both tumor and underlying cirrhosis. HCC could be downstaged or controlled by various anticancer therapies, which might bring them chance of undergoing a curative treatment such as LT

Aim of the Work: it was to evaluate the outcomes of HCC downstaged patients using transarterial hepatic chemoembolization [TACE] therapy to allow eligibility for liver transplantation

Patients and Methods: the study included all the cirrhotic patients who underwent TACE for downstaging of HCC to become eligible for liver transplantation at the period from 2008 to 2017 in Ain Shams Specialized Hospital. Al the patients underwent TACE to meet the Milan criteria for liver transplantation

Results: the etiology of cirrhosis and HCC in our patients was primarily Hepatitis C virus which is endemic in our country. All the cases were not eligible for liver transplantation because they were out of Milan criteria, therefore all the cases underwent TACE for downstaging of the tumor to be within the Milan criteria to become fit for liver transplantation. After undergoing TACE for downstaging, Patients underwent living donor liver transplantation, then they were followed up for detection of recurrence on the transplanted liver. Four of the twenty seven patients had recurrent HCC [14.8 %]

Conclusion: successful down-staging of HCC by TACE can be achieved in the majority of carefully selected patients and is associated with excellent posttransplantation outcome

Role of Pet/Ct in assessment of post therapeutic hepatocellular carcinoma

Aim of the work: this study aimed to highlight the role of PET/CT in evaluation of post-therapeutic hepatocellular carcinoma, hence guiding the clinician to proper management strategy

Patients and methods: 35 patients [32 male and 3 female] were included in this study. All patients had history of local treatment of HCC; most of the cases were treated with TACE or RFA. They had undergone 18F-FDG PET/CT for evaluation of the therapeutic effect after the end of the therapy

Results: our study demonstrated that 18F-FDG PET/CT is a significant prognostic factor for tumor recurrence in post-therapeutic HCC with a cutoff TSUVmax/LSUVmax value of 1.3

Conclusion: 18F-FDG PET/CT imaging have a prognostic significance in evaluation of patients with posttherapeutic HCC and provide valuable information that can be used in the treatment response evaluation and clinical decision making process