Pathological response after degradable starch microspheres transarterial chemoembolization for hepatocellular carcinoma: a Histopathological study on explanted livers

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-09-25 DOI:10.1016/j.ejrad.2025.112454

Federico Collettini , Hannes Gottschalk , Timo Alexander Auer , Christoph Röcken , Florian Roßner , Barbara Heitplatz , Max Masthoff , Julian Andersson

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引用次数: 0

Abstract

Purpose

To evaluate the pathological response after degradable starch microspheres transarterial chemoembolization (DSM-TACE) conducted to bridge or downstage hepatocellular carcinoma (HCC) patients to liver transplantation.

Materials and methods

A multi-center retrospective study was conducted on consecutive patients with HCC who underwent liver transplantation after receiving DSM-TACE as a stand-alone therapy for bridging or downstaging between January 1, 2010, and December 31, 2022. Pathological response was evaluated histologically by board certified surgical pathologists. Tumor necrosis was estimated histologically as a percentage area of the total tumor area. The criteria for estimation of pathological response were established as follows: (1) Complete pathological response: 100% tumor necrosis and absence of any viable tumor cells; (2) Significant pathological response: 50–99% tumor necrosis in cross section; (3) Mild pathological response: 1–49% tumor necrosis in cross section and (4) No pathological response: no tumor necrosis present.

Results

Twenty-two patients (16 men; median age, 65 years) with 73 HCCs (median largest diameter: 2.7 cm) were bridged or downstaged with DSM-TACE and subsequently underwent liver transplantation. Histopathological examination of the explanted livers showed complete pathological response in 27 % of patients, significant pathological response in 32 %, mild pathological response in 27 % and no pathological response in 14 %.

Conclusion

The present study provides important clinical evidence supporting the efficacy of DSM-TACE in inducing tumor necrosis, despite its short embolization time.

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可降解淀粉微球经动脉化疗栓塞治疗肝癌后的病理反应：外植肝的组织病理学研究。

目的：评价可降解淀粉微球经动脉化疗栓塞（DSM-TACE）桥接或下行期肝癌患者肝移植后的病理反应。材料和方法：在2010年1月1日至2022年12月31日期间，对连续接受DSM-TACE作为桥接或降期独立治疗后接受肝移植的HCC患者进行了一项多中心回顾性研究。病理反应由委员会认证的外科病理学家进行组织学评估。从组织学上估计肿瘤坏死占肿瘤总面积的百分比。病理反应的判断标准如下：(1)完全病理反应：肿瘤坏死100%，无活细胞；(2)病理反应显著：切面肿瘤坏死50-99%；(3)轻度病理反应：横切面肿瘤坏死1-49%；(4)无病理反应：无肿瘤坏死。结果：22名患者（16名男性，中位年龄65岁）73例hcc（中位最大直径2.7 cm）通过DSM-TACE桥接或下行，随后进行肝移植。组织病理学检查显示，27%的患者病理反应完全，32%的患者病理反应显著，27%的患者病理反应轻微，14%的患者无病理反应。结论：本研究提供了重要的临床证据，支持DSM-TACE虽然栓塞时间短，但在诱导肿瘤坏死方面的疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.