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Revisiting the role of pathological analysis in transarterial chemoembolization-treated hepatocellular carcinoma after transplantation
- Publication Year :
- 2014
-
Abstract
- AIM: To define the histopathological features predictive of post-transplant hepatocellular carcinoma (HCC) recurrence after transarterial chemoembolization, applicable for recipient risk stratification. METHODS: We retrospectively reviewed the specimens of all suspicious nodules (total 275) from 101 consecutive liver transplant recipients which came to our Pathology Unit over a 6-year period. All nodules were sampled and analyzed, and follow-up data were collected. We finally considered 11 histological variables for each patient: total number of nodules, number of viable nodules, size of the major nodule, size of the major viable nodule, occurrence of microscopic vascular invasion, maximum Edmondson's grade, clear cell/sarcomatous changes, and the residual neoplastic volume. Survival data were computed by means of the Kaplan-Meier procedure and analyzed by means of the Cox proportional hazards model. The multivariate linear regression and a k-means cluster analysis were also used in order to compute the standardized histological score. RESULTS: The total number of nodules, the residual neoplastic volume (the total volume of all evaluated nodules minus the necrotic portion) and the microvascular invasion entered the Cox multivariate hazard model with HCC recurrence as dependent variable. The histological score was therefore computed and a cluster analysis sorted recipients into 3 risk groups, with 3.3%, 18.5% and 53.8% respectively of tumor recurrence rates and 1.6%, 11.1% and 38.5% of tumor-related mortality respectively at the end of follow-up. CONCLUSION: The histological score allows a reliable stratification of HCC recurrence risk, especially in those recipients found out to be beyond the Milan criteria after orthotopic liver transplantation (OLT).
- Subjects :
- Adult
Male
medicine.medical_specialty
Pathology
Carcinoma, Hepatocellular
Time Factors
medicine.medical_treatment
Kaplan-Meier Estimate
Liver transplantation
Milan criteria
Risk Assessment
Risk Factors
Retrospective Study
medicine
Humans
HEPATOCELLULAR CARCINOMA
Chemoembolization, Therapeutic
CHEMOEMBOLIZATION
Neoadjuvant therapy
Aged
Neoplasm Staging
Proportional Hazards Models
Retrospective Studies
Proportional hazards model
business.industry
Liver Neoplasms
Gastroenterology
Nodule (medicine)
General Medicine
Middle Aged
medicine.disease
digestive system diseases
Neoadjuvant Therapy
Liver Transplantation
Transplantation
Treatment Outcome
Italy
Chemotherapy, Adjuvant
Hepatocellular carcinoma
Multivariate Analysis
Linear Models
Female
Histopathology
Radiology
Neoplasm Recurrence, Local
medicine.symptom
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....a4a08c6142fc4eacf40a3d63434d52f7