Mechanism and Natural Course of Tumor Involution in Hepatocellular Carcinoma Following Transarterial Ethanol Ablation

Journal Article · Mon Aug 15 04:00:00 EDT 2016 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-016-1360-Z· OSTI ID:22645477

Lau, Tiffany Wing Wa; Tang, Peggy; Chan, Stephen Ka Chi; Chu, Charmant Cheuk Man; Hui, Joyce Wai Yi ^[1]; Lee, Kit Fai ^[2]; Chan, Anthony ^[3]

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1. The Chinese University of Hong Kong, Department of Imaging and Interventional Radiology, Prince of Wales Hospital (Hong Kong)
2. Prince of Wales Hospital, Department of Surgery (Hong Kong)
3. The Chinese University of Hong Kong, Department of Anatomical and Cellular Pathology (Hong Kong)

PurposeTo evaluate the microvascular distribution of lipiodol–ethanol, the histological change of the tumor lesion, and the status of tumor involution over time in hepatocellular carcinoma (HCC) following transarterial ethanol ablation (TEA), in lesions that showed CT evidence of complete tumor response.Materials and methodsPatients with unresectable HCC were treated (183 patients, 242 lesions) with TEA using lipiodol–ethanol mixture (LEM) mixed in 2:1 ratio by volume and followed with CT at 3-month intervals for a median of 14.1 months. Liver tumors (n = 131) that showed CT evidence of complete tumor response, defined as the absence of any enhancing tumor throughout the follow-up period, were included. The surgical specimens of five patients who subsequently received partial hepatectomy were available for histological assessment. The microvascular distribution of LEM and the degree of tumor necrosis were analyzed. Tumor involution over time was assessed with CT in lesions that showed complete response.ResultsLipid stain revealed lipiodol infiltration throughout arterioles, intratumoral sinusoidal spaces, tumor capsule, and peritumoral portal venules. Complete tumor necrosis (100 %) occurred in all 5 surgical specimens. The median (IQR) percentage tumor volume compared to baseline volumes at 12, 36, and 60 months was 32 % (23.5–52.5 %), 22 % (8–31 %), and 13.5 % (6–21.5 %), respectively.ConclusionIntrahepatic HCC lesion that showed CT evidence of complete tumor response following TEA is associated with histological evidence of LEM infiltration throughout the intratumoral and peritumoral vasculature and complete tumor necrosis, as well as sustained reduction in tumor volume over time.

• OSTI ID: 22645477
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 8 Vol. 39; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ABLATION
BEVERAGES
COMPUTERIZED TOMOGRAPHY
ETHANOL
HEPATECTOMY
HEPATOMAS
LIPIODOL
LIVER
NECROSIS
PATIENTS