Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide. Prognosis of patients with HCC complicating cirrhosis mainly depends on the tumor growth, progression of the underlying liver disease and the effectiveness of antitumoral treatment.
Trans-catheter treatment is extensively used to treat HCC not suitable for surgical resection or percutaneous ablation therapies. Unfortunately, the tumor response after trans-catheter treatment is heterogeneous, with a wide range of necrosis that cannot be accurately predicted.
A study, published on the issue 45 of World Journal of Gastroenterology, led by Dr. Roberto Miraglia from the Mediterranean Institute for Transplantation and Advanced Specialized Therapies, evaluated the pre-treatment imaging and clinical variables of two hundred cirrhotic patients with HCC underwent trans-catheter treatment.
The research showed that massive necrosis after trans-catheter treatment is more common in the presence of tumor capsule, with a maximum diameter of the main lesion between 2 - 6 cm, CLIP score < 2 and the absence of constitutional syndrome.
The ability to predict which patients could respond to trans-catheter treatment could be useful in clinical decision making and to stratify patient randomization in therapeutic clinical trials.