3:27 PM Abstract No. 36 Comparison of pathologic treatment response between conventional and doxorubicin-eluting bead chemoembolization in explanted livers

Abstract

Purpose: To compare pathologic treatment response between conventional (cTACE) and doxorubicin-eluting bead chemoembolization (DEB-TACE) in explanted livers. Materials: A retrospective review was performed of all patients who received treatment with either cTACE or DEB-TACE that subsequently had a liver transplant from June 2009 to June 2016. A total of 200 unique patients were identified. 128 patients met inclusion criteria of having hepatocellular carcinoma (HCC) on pathology, quantitative tumor viability pathology reports, and only having one type of TACE (cTACE (n ¼ 95) and DEB-TACE (n ¼ 33)) before explant. Only treated tumors were included. Time interval between last TACE and liver transplant was a mean of 134 days (range, 1 -496 days). Student t-test was used to compare means and chi square test was used to compare categorical variables. Results: 173 tumors were identified in these 128 patients, with 124 tumors in the cTACE group and 49 tumors in the DEB-TACE group. Tumor grade was similar in both groups. Average number of treatments were 1.62 (SD: 0.82) in the cTACE group and 1.47 (SD: 0.66) in the DEB-TACE group. Categories of pathologic tumor response were 0%, h50%, i50%, and 100% viability. 0% viability was seen in 32/124 (25.8%) tumors in the cTACE group and 10/49 (20.4%) tumors in the DEB-TACE group. h50% viability was seen in 48/124 (38.7%) tumors in the cTACE group and 23/49 (46.9%) in the DEB-TACE group. i50% viability was seen in 33/124 (26.6%) in the cTACE group and 14/49 (28.6%) in the DEB-TACE group. The mean tumor viability after cTACE and DEB-TACE treatments were 41.8% and 38.8% respectively. The pathologic treatment response between both groups did not approach statistical significance (p ¼ 0.50). Conclusions: In this study, no difference in pathologic treatment response was seen in HCC treated with cTACE and DEB-TACE. Either cTACE or DEB-TACE can be an acceptable treatment to achieve tumor control for patients awaiting liver transplant.