|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Doxorubicin-eluting bead vs conventional transcatheter arterial chemoembolization for hepatocellular carcinoma before liver transplantation显示文摘AIM:To assess the possible effect of two different types of preoperative transcatheter arterial chemoembolization(TACE)on recurrence-free survival after liver transplantation(LT)in patients with hepatocellular carcinoma(HCC)and to analyze the effects of TACE on tumor histology.METHODS:We retrospectively analyzed the histological features of 130 HCC nodules in 63 native livers removed at transplantation.Patients who received any other type of treatment such as radiofrequency tumor ablation,percutaneous ethanol ablation or who were not treated at all were excluded.All patients in the present study were within the Milan Criteria at the last imaging findings before transplantation.Doxorubicineluting bead TACE(DEB-TACE)was performed in 22patients(38 nodules),and conventional TACE(c-TACE)in 16(25 nodules).Patients’and tumors’characteristics were retrospectively reviewed.We performed a pernodule analysis of the explanted livers to establish the mean percentage of necrosis of any nodule treated by TACE(conventional or DEB)and a per-patient analysis to establish the percentage of necrosis in the cumulative tumor area,including 21 nodules not reached by TACE.Inflammatory and fibrotic changes in the tissue surrounding the tumor nodule were analyzed and categorized as poor/absent,moderate and enhanced reaction.Uni-and multivariate analysis of risk factors for HCC-recurrence were performed.RESULTS:The number and diameter of the nodules,the time spent on the waiting list and the number of treatments were similar in the two groups.A trend towards higher appropriate response rates(necrosis≥90%)was observed in the DEB-TACE group(44.7%vs32.0%,P=0.2834).The mean percentage of necrosis in the cumulative tumor area was 58.8%±36.6%in the DEB-TACE group and 50.2%±38.1%in the c-TACE group(P=0.4856).Fibrotic and inflammatory reactions surrounding the tumor nodule were markedly more common in the DEB-TACE group(P<0.0001,for both the parameters).The three-year recurrence-free survival was higher in DEB-TACE-treated patients than in conventionally treated patients(87.4%vs 61.5%,P=0.0493).Other factors affecting recurrence-free survival included viable tumor beyond Milan Criteria on histopathological examination,the percentage of necrosis on CTA≤50%and a pre-transplant serum-fetoprotein level greater than 70 ng/mL.On multivariate analysis,the lack of treatment with DEB-TACE,high levels of-fetoprotein and viable tumor beyond Milan Criteria at histology examination were identified as independent predictors of tumor recurrence.CONCLUSION:DEB-TACE can effectively promote tumor necrosis and improves recurrence-free survival after LT in HCC. | Daniele Nicolini Gianluca Svegliati-Baroni Roberto Candelari Cinzia Mincarelli Alessandra Mandolesi Italo Bearzi Federico Mocchegiani Andrea Vecchi Roberto Montalti Antonio Benedetti Andrea Risaliti Marco Vivarelli | 2013 | World Journal of Gastroenterology2013，19，34： | 12 |
| 2 | Radiological response and inflammation scores predict tumour recurrence in patients treated with transarterial chemoembolization before liver transplantation显示文摘AIM To investigate the prognostic value of the radiological response after transarterial chemoembolization(TACE)and inflammatory markers in patients affected by hepatocellular carcinoma(HCC)awaiting liver transplantation(LT).METHODS We retrospectively evaluated the preoperative pre dictors of HCC recurrence in 70 patients treated with conventional(n=16)or doxorubicin-eluting bead TACE(n=54)before LT.The patient and tumour characteristics,including the static and dynamic alpha-fetoprotein,neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio( LR)measurements,were recorded.Treatment response was classified according to the modified Response Evaluation Criteria in Solid Tumours(m RECIST)and the European Association for the Study of the Liver(EASL)criteria as complete response(CR),partial response( R),stable disease o progressive disease.After examination of the explanted livers,histological necrosis was classified as complete(100%of the cumulative tumour area),partia(50%-99%)or minimal(<50%)and was correlated with the preoperative radiological findings.RESULTS According to the pre-TACE radiological evaluation,22/70(31.4%)and 12/70(17.1%)patients were beyond Milan and University of San Francisco(UCSF)criteria,respectively.After TACE procedures,the objective response(CR+ R)rates were 71.4%and 70.0%according to m RECIST and EASL criteria,respectively.The agreement between the two guidelines in defining the radiological response was rated as very good both for the overall and target lesion response(weighted k-value:0.98 and 0.93,respectively).Complete and partial histological necrosis were achieved in 14/70(20.0%)and 28/70(40.0%)patients,respectively.Using histopathology as the reference standard,m RECIST criteria correctly classified necrosis in 72.9%(51/70)of patients and EASL criteria in 68.6%(48/70)of cases.The m RECIST non-response to TACE[Exp(b)=9.2, =0.012],exceeding UCSF criteria before TACE[Exp(b)=4.7, =0.033]and a preoperative LR>150[Exp(b)=5.9, =0.046]were independent predictors of tumour recurrence.CONCLUSION The radiological response and inflammatory markers are predictive of tumour recurrence and allow the proper selection of TACE-treated candidates for LT. | Daniele Nicolini Andrea Agostini Roberto Montalti Federico Mocchegiani Cinzia Mincarelli Alessandra Mandolesi Nicola L Robertson Roberto Candelari Andrea Giovagnoni Marco Vivarelli | 2017 | World Journal of Gastroenterology2017，23，20： | 4 |
| 3 | Pseudoaneurysm of the Common Hepatic Artery: Treatment with a Stent-Graft显示文摘 | Enrico Paci Ettore Antico Roberto Candelari Salvatore Alborino Cristina Marmorale Eduardo Landi | 2000 | CardioVascular and Interventional Radiology2000，，6： | 3 |
| 4 | Pseudoaneurysm of the Common Hepatic Artery: Treatment with a Stent-Graft显示文摘 | Enrico Paci Ettore Antico Roberto Candelari Salvatore Alborino Cristina Marmorale Eduardo Landi | 2000 | CardioVascular and Interventional Radiology2000，，6： | 1 |
| 5 | Influence of the Heat Treat- ment on the Corrosion Resistance of the Martensitic Stainless Steel Type AISI 420显示文摘 | Candelarial A F Pinedol C E | 2003 | Journal of Materials Science Letters2003，22，： | 1 |
| 6 | Ozone ret) ment reduces markers of oxidative and endothelial damage in an experi mental tiabeles model in rals 显示文摘 | A12 Dalain S M Mar) i nez G Candelari oJ | 2001 | Phar macol ties2001，44，5： | 1 |
您所在的机构暂未开通此部分的功能，请联系管理员