Effectiveness of superselective chemoembolization and radiofrequency ablation of hepatocellular carcinoma assessed in 21 explanted livers.

The efficacy of superselective transcatheter chemoembolization (TACE) and chemoembolization taking advantage of pharmacologic (noradrenaline) flow manipulation was assessed on 21 explanted livers with hepatocellular carcinoma (HCC). There was a high concentration of chemoembolizate in the target area. Correlation of gross anatomical and immunohistochemical findings (gold standard) of tumor volume, necrosis and residual viable tumor to predicted results by multiphasic helical computed tomography (CT) was poor. Tumor markers in explanted livers found free of tumor were low or absent; in livers with residual or recurrent tumor high. However, there did not appear to be a correlation between the degree of tumor necrosis and level of tumor markers. The recurrence-free post-orthotopic liver transplant (OLT) survival in our 21 patients appears to be substantially lower than that reported in the literature. The goal of retaining patients on the liver transplant list by repeated TACE or multimodality therapy (MMT) was achieved (drop out rate of only 16%).