Imaging response predictors following drug eluting beads chemoembolization in the neoadjuvant liver transplant treatment of hepatocellular carcinoma

Galastri, Francisco Leonardo; Nasser, Felipe; Affonso, Breno Boueri; Valle, Leonardo Guedes Moreira; Odisio, Bruno C.; Filho, J.M. Motta Leal; Salvalaggio, Paolo R.O.; Garcia, Rodrigo Gobbo; Almeida, Márcio Dias de; Baroni, Ronaldo Hueb; Wolosker, Nelson

doi:10.4254/wjh.v12.i1.21

Cited by 8 publications

(8 citation statements)

References 26 publications

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“…This study did not assess post-treatment eligibility for resection and therefore the translation of response rates into resectability is unclear. While subsequent studies have assessed DEB-TACE as a bridging therapy prior to liver transplant (27)(28)(29), the role of this treatment modality as a conversion therapy prior to surgical resection requires further confirmation.…”

Section: Locoregional Treatment For Conversion Therapy Transarterial Chemoembolizationmentioning

confidence: 99%

Downstaging Conversion Therapy in Patients With Initially Unresectable Advanced Hepatocellular Carcinoma: An Overview

Sun

Zhu

2021

Front. Oncol.

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The high mortality rate associated with hepatocellular carcinoma (HCC) is partly due to the high proportion of patients who present with advanced stage disease at diagnosis, for whom there are limited treatment options. For selected patients with initially unresectable HCC, locoregional and/or systemic treatments can result in tumor downstaging and consequently provide opportunities for surgical intervention and the potential for long-term survival. Therefore, the key aim of ‘conversion therapy’ is to reduce tumor burden so that patients become amenable to surgical resection. Various therapies have been investigated as candidates for downstaging patients with potentially resectable HCC including transarterial chemoembolization, transarterial radioembolization with yttrium-90 microspheres, radiotherapy, systemic therapies and combination or multimodality treatment approaches. However, downstaging conversion therapy remains controversial and there are several challenges such as defining the criteria used to identify the population of patients who are ‘potentially resectable’, the criteria used to define successful downstaging, and the optimum treatment approach to maximize the success of downstaging therapy. In this review article, we summarize clinical experience and evidence of downstaging conversion treatment in patients identified as having ‘potentially resectable’ HCC.

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Section: Locoregional Treatment For Conversion Therapy Transarterial Chemoembolizationmentioning

confidence: 99%

Downstaging Conversion Therapy in Patients With Initially Unresectable Advanced Hepatocellular Carcinoma: An Overview

Sun

Zhu

2021

Front. Oncol.

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“…In recent years, drug-eluting bead TACE (DEB-TACE), degradable starch microsphere TACE (DSM-TACE), Yttrium-90 radioembolization, and stereotactic body radiation therapy (SBRT), etc., have been used as bridging and downstaging modalities instead of conventional methods. [ 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 ]. DEB-TACE enables the maintenance of high concentrations of the drug in the tumor and fewer systemic adverse effects compared to conventional TACE by slowly and continuously releasing the anti-cancer drug locally.…”

Section: Variations Of Pre-transplant Locoregional Therapiesmentioning

confidence: 99%

Role of Pretransplant Treatments for Patients with Hepatocellular Carcinoma Waiting for Liver Transplantation

Ogawa

Takada

2022

Cancers

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Recently, there have been many reports of the usefulness of locoregional therapy such as transarterial chemoembolization and radiofrequency ablation for hepatocellular carcinoma (HCC) as pretreatment before liver transplantation (LT). Locoregional therapy is performed with curative intent in Japan, where living donor LT constitutes the majority of LT due to the critical shortage of deceased donors. However, in Western countries, where deceased donor LT is the main procedure, LT is indicated for early-stage HCC regardless of liver functional reserve, and locoregional therapy is used for bridging until transplantation to prevent drop-outs from the waiting list or for downstaging to treat patients with advanced HCC who initially exceed the criteria for LT. There are many reports of the effect of bridging and downstaging locoregional therapy before LT, and its indications and efficacy are becoming clear. Responses to locoregional therapy, such as changes in tumor markers, the avidity of FDG-PET, etc., are considered useful for successful bridging and downstaging. In this review, the effects of bridging and downstaging locoregional therapy as a pretransplant treatment on the results of transplantation are clarified, focusing on recent reports.

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“…In the IR arena, there are a multitude of studies investigating such predictors. [19][20][21][22][23][24] Some investigators have studied AI for these purposes. Abajian et al used ML in prelocoregional therapy MR to predict hepatocellular carcinoma response.…”

Section: Clinical Decision Makingmentioning

confidence: 99%

Artificial Intelligence in Interventional Radiology

Kallini

Moriarty

2022

Semin intervent Radiol

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Imaging response predictors following drug eluting beads chemoembolization in the neoadjuvant liver transplant treatment of hepatocellular carcinoma

Cited by 8 publications

References 26 publications

Downstaging Conversion Therapy in Patients With Initially Unresectable Advanced Hepatocellular Carcinoma: An Overview

Downstaging Conversion Therapy in Patients With Initially Unresectable Advanced Hepatocellular Carcinoma: An Overview

Role of Pretransplant Treatments for Patients with Hepatocellular Carcinoma Waiting for Liver Transplantation

Artificial Intelligence in Interventional Radiology

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