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Master Thesis

Corrélation radio-anatomique dans le carcinome hépato cellulaire traité par transplantation hépatique‎ : impact de la chimioembolisation néoadjuvante

Abstract : Nowadays, the liver organ allocation depends on Milan criteria which have been extended recently with AFP score, taking into account number and size of viable nodules and AFP level. The study was designed to evaluate the reproducibility of this criteria and the viable tumor after neo-adjuvant TACE, using a radiological-pathological correlation, and determine the impact on HCC recurrence and survival after liver transplantation. One hundred consecutive patients transplanted for HCC in a unique centre between 2005 and 2012 were included. A neo-adjuvant TACE was performed for 54 patients. A comparison was made between the last imaging done before LT and histology. A significant correlation between imaging and histology was observed for the total tumor size (r=0.77, p=0.001) and the number of nodules (r=0.77, p=0.001). Ninety six nodules, mostly of small size (11.2mm) were seen on histology but not on imaging, with no impact on recurrence. There was a good concordance for Milan criteria between imaging and histology (81%) but lower than for AFP score (90%). The mean tumor necrosis was 68% on imaging and 57% on histology. Among the patients who had a complete tumor response on imaging, only 28% actually had a total tumor necrosis on histology. Using the viable tumor on imaging, the probability of recurrence at 5 years was significantly higher for patients at high risk in AFP score compared with low risk (33.3% vs 14.6%, p=0.02). There were no differences on recurrence between Milan criteria and AFP score, but AFP score allowed LT to 13% more patients compared with Milan criteria. This study validates the use of viable tumor and AFP score for liver transplantation listing.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-00868068
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Submitted on : Tuesday, October 1, 2013 - 9:48:32 AM
Last modification on : Tuesday, May 11, 2021 - 11:36:17 AM
Long-term archiving on: : Friday, April 7, 2017 - 4:35:20 AM

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  • HAL Id : dumas-00868068, version 1

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Laetitia Lecoq. Corrélation radio-anatomique dans le carcinome hépato cellulaire traité par transplantation hépatique‎ : impact de la chimioembolisation néoadjuvante. Médecine humaine et pathologie. 2013. ⟨dumas-00868068⟩

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