Small diameter DEB-TACE for liver cancer before liver transplantation / 中华肝胆外科杂志

ABSTRACT

Objective:To study the short-term safety and efficacy of small diameter drug-eluting beads-transcatheter arterial chemoembolization (DEB-TACE) for patients with liver cancer before liver transplantation.Methods:From Mar 2018 to Dec 2019, 47 patients underwent small diameter DEB-TACE for liver cancer before liver transplantation. There were 39 males and 8 females, aged 24 to 70 years (median 51.5 years). Analysis of tumor size, tumor number and complications was conducted after DEB-TACE. After DEB-TACE, tumor response evaluation was done according to the modified response evaluation criteria in solid tumors criteria. Ananlyze the elimination rate and downstaged rate during liver transplantation waiting period. For patients who underwent liver transplantation, the pathological findings and the tumor recurrence of patients were analysed.Results:There were 46 patients Child-Pugh A, 1 patient Child-Pugh B. A solitary liver cancer was found in 17 patients, and multiple tumors in 30 patients. The lesion size was (30.8±17.7)mm. For the 47 patients who together underwent 50 times DEB-TACE. The technical success rate was 100.0%, the complete response rate 27.7%(13/47), partial response rate 51.1%(24/47), stable disease rate 17.0%(8/47), and progressive disease rate 4.2%(2/47). For the 22 patients who met the Milan cirteria and were awaiting for transplantation, the elimination from transplantation rate was 0. For the 25 patients who are beyond the cirteria and who underwent DEB-TACE, 84.0% (21/25) of patients were downstaged to within the University of California, San Francisco cirteria and 56.0% (14/25) to within the Milan cirteria. For the 35 patients who underwent liver transplantation, pathology showed that complete necrosis rate was 39.4%(13/33), and more than 50 % necrosis was achieved in 26 of 33 patients(78.8%). No significant treatment related complications were observed. Only 3.0%(1/33) of patients suffered from tumor recurrence.Conclusion:Small diameter DEB-TACE for liver cancer was an effective procedure with a favorable safety profile and promising results in tumor necrosis rates.