Sotiropoulos Georgios C, Malago M, Molmenti E P, Radtke A, Brokalaki E I, Nadalin S, Lang H, Frilling A, Baba H A, Kühl H, Verhagen R, Broelsch C E
Department of General Surgery and Transplantation, University Hospital Essen, Germany.
Eur J Med Res. 2005 Dec 7;10(12):539-42.
To study the disease course of patients with hepatocellular carcinoma (HCC) showing complete tumor necrosis in their liver explants after undergoing bridging treatments followed by liver transplantation (LTx).
We evaluated data corresponding to 10 patients with liver cirrhosis undergoing bridging treatments for HCC prior to LTx. In all cases there was complete tumor necrosis in the explanted livers.
There were 8 men and 2 women. Percutaneous radiofrequency ablation (RFA) was performed under computed tomographic guidance in 4 patients. The remaining 6 patients underwent transarterial chemoembolization (TACE). Five of them received one session of TACE, while the remaining one received a series of 4 sessions prior to LTx. Six patients had solitary nodules with a median diameter of 3.5 cm (range 2.5-4.2 cm). Four of them underwent RFA. Segmental tumor chemoembolization was performed in 2 patients. The remaining 4 patients had 2 tumors each with a median total diameter of 4.4cm (range 4.2-6.0 cm) prior to TACE. They underwent bilobar hepatic chemoembolization, which under staged the tumors prior to live donor liver transplantation (LDLTx). Six patients underwent deceased donor orthotopic liver transplantation. LDLTx was performed in 4 patients. Median waiting time to LTx was 53 days. All patients are alive without recurrence after a median follow-up of 19 months.
Achievement of 100% tumor necrosis by means of bridging treatments followed by LTx for HCC is characterized by a very low recurrence rate and should receive further consideration and study.
研究经桥接治疗后行肝移植（LTx）的肝细胞癌（HCC）患者，其肝外植体显示肿瘤完全坏死的疾病进程。
我们评估了10例肝硬化患者在LTx前接受HCC桥接治疗的数据。所有病例的肝外植体均有肿瘤完全坏死。
8例男性，2例女性。4例患者在计算机断层扫描引导下进行了经皮射频消融（RFA）。其余6例患者接受了经动脉化疗栓塞（TACE）。其中5例接受了1次TACE，其余1例在LTx前接受了4次TACE。6例患者有孤立结节，中位直径为3.5 cm（范围2.5 - 4.2 cm）。其中4例接受了RFA。2例患者进行了节段性肿瘤化疗栓塞。其余4例患者在TACE前有2个肿瘤，中位总直径为4.4 cm（范围4.2 - 6.0 cm）。他们接受了双叶肝化疗栓塞，这在活体供肝肝移植（LDLTx）前对肿瘤进行了分期。6例患者接受了尸体供肝原位肝移植。4例患者进行了LDLTx。LTx的中位等待时间为53天。所有患者在中位随访19个月后均存活且无复发。
通过桥接治疗后对HCC进行LTx实现100%肿瘤坏死，其特点是复发率极低，应进一步予以考虑和研究。
