Copyright
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Imaging response predictors following drug eluting beads chemoembolization in the neoadjuvant liver transplant treatment of hepatocellular carcinoma
Francisco Leonardo Galastri, Felipe Nasser, Breno Boueri Affonso, Leonardo Guedes Moreira Valle, Bruno Calazans Odísio, Joaquim Mauricio Motta-Leal Filho, Paolo Rogério Salvalaggio, Rodrigo Gobbo Garcia, Márcio Dias de Almeida, Ronaldo Hueb Baroni, Nelson Wolosker
Francisco Leonardo Galastri, Felipe Nasser, Breno Boueri Affonso, Leonardo Guedes Moreira Valle, Rodrigo Gobbo Garcia, Department of Interventional Radiology, Hospital Israelita Albert Einstein, São Paulo 05652-000, Brazil
Bruno Calazans Odísio, Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77230, United States
Joaquim Mauricio Motta-Leal Filho, Radiology Department, Radiology Department, Heart Institute (InCor), University of São Paulo, São Paulo 05403-900, Brazil
Paolo Rogério Salvalaggio, Teaching and Research Institute, São Paulo, Brazil, Hospital Israelita Albert Einstein, São Paulo 05652-000, Brazil
Márcio Dias de Almeida, Department of Liver Transplant, Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil
Ronaldo Hueb Baroni, Department of Radiology, Hospital Israelita Albert Einstein, São Paulo 05652-000, Brazil
Nelson Wolosker, Department of Vascular Surgery, Hospital Israelita Albert Einstein, São Paulo 05652-000, Brazil
Author contributions: Galastri FL designed the research study, performed procedures and wrote the paper; Nasser F, Affonso BB and Valle LGM contributed equally to this work, performed procedures and participated in the research; Odísio BC contributed to the project and review; Motta-Leal Filho JM and Salvalaggio PR contributed equally with research and statistical analysis; Garcia RG and Baroni RH contributed equally to radiological evaluation and analytical tools; de Almeida MD contributed to the clinical evaluation and follow-up of patients; Wolosker N contributed to the study project and writing of the paper.
Institutional review board statement: This study was approved by the local institutional review board (CAAE 0199.0.028.000-11).
Informed consent statement: Written informed consent was obtained from all patients in this study.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
STROBE statement: The authors have read the STROBE statement, and the manuscript was prepared and revised according to the STROBE statement.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Francisco Leonardo Galastri, MD, PhD, Staff Physician, Department of Interventional Radiology, Hospital Israelita Albert Einstein, Avenida Albert Einstein, 627, São Paulo 05652-000, Brazil. leogalastri@gmail.com
Received: July 12, 2019
Peer-review started: July 16, 2019
First decision: August 7, 2019
Revised: October 2, 2019
Accepted: December 6, 2019
Article in press: December 6, 2019
Published online: January 27, 2020
ARTICLE HIGHLIGHTS
Research background
Drug-eluting bead transarterial chemoembolization (DEB-TACE) minimizes systemic exposure and adverse effects to chemotherapeutics in hepatocellular carcinoma (HCC) patients.
Research motivation
Predictors of the response after DEB-TACE still have not been fully elucidated.
Research objectives
Identifying characteristics which may predict imaging response can improve treatment results and select the best candidates.
Research methods
This was a single center, observational cohort prospective study.
Research results
Pseudocapsule increases by 2.01 times the chance of HCC to be responder and 18.27% more necrosis in treated HCCs. Every milligram of the chemoembolic agent administered causes a 4% increase the chance of HCC to be a responder and increase of 0.65% in necrosis.
Research conclusions
Pseudocapsule and the addition of the amount of chemoembolic agent are imaging response predictors following drug eluting beads chemoembolization in the neoadjuvant liver transplant treatment of hepatocellular carcinoma.
Research perspectives
Identify what other criteria not evaluated in this study may also be important additional factors explaining the post-DEB-TACE radiological response in the neodjuvant treatment of hepatocarcinoma.
