BACKGROUND & AIMS: Although potentially very useful in optimizing patient selection and follow-up, the individual response to transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC) is generally unpredictable. The aim of this study was to identify tissue predictors of tumour resistance to TACE for use in clinical practice on pretreatment biopsies. METHODS: We investigated the association of residual tumour in post-TACE-resected HCC with pathological and immunophenotypical features, mainly related to hypoxia and angiogenesis. Comparison of tumour phenotype between post-TACE HCC and both paired pre-TACE biopsies and control TACE-untreated HCC was performed. Cases showing >50% residual tumour (RT) were defined as TACE-resistant. RESULTS: A consecutive series of 108 HCC from 41 patients was studied. Overall, 45/108 (44%) HCC were classified as TACE-resistant. Among these, 32 (71%) and 40 (89%) showed diffuse CD34 vascular staining and negative VEGF staining respectively (p<0.05). The association of these two parameters in a weighted score (TRIP) was able to predict TACE resistance with 81% accuracy, 89% sensitivity and 59% specificity. The effectiveness of TRIP was validated in an independent series of 28 HCC biopsies from patients subsequently treated with TACE and for whom radiological follow-up was available. CONCLUSIONS: This study demonstrates the potential value of pretreatment tumour biopsy as predictors of TACE resistance in HCC.
BACKGROUND & AIMS: Although potentially very useful in optimizing patient selection and follow-up, the individual response to transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC) is generally unpredictable. The aim of this study was to identify tissue predictors of tumour resistance to TACE for use in clinical practice on pretreatment biopsies. METHODS: We investigated the association of residual tumour in post-TACE-resected HCC with pathological and immunophenotypical features, mainly related to hypoxia and angiogenesis. Comparison of tumour phenotype between post-TACE HCC and both paired pre-TACE biopsies and control TACE-untreated HCC was performed. Cases showing >50% residual tumour (RT) were defined as TACE-resistant. RESULTS: A consecutive series of 108 HCC from 41 patients was studied. Overall, 45/108 (44%) HCC were classified as TACE-resistant. Among these, 32 (71%) and 40 (89%) showed diffuse CD34 vascular staining and negative VEGF staining respectively (p<0.05). The association of these two parameters in a weighted score (TRIP) was able to predict TACE resistance with 81% accuracy, 89% sensitivity and 59% specificity. The effectiveness of TRIP was validated in an independent series of 28 HCC biopsies from patients subsequently treated with TACE and for whom radiological follow-up was available. CONCLUSIONS: This study demonstrates the potential value of pretreatment tumour biopsy as predictors of TACE resistance in HCC.
Authors: Kibo Nam; Maria Stanczak; Andrej Lyshchik; Priscilla Machado; Yuko Kono; Flemming Forsberg; Colette M Shaw; John R Eisenbrey Journal: Biomed Phys Eng Express Date: 2018-04-18
Authors: Adam Polikoff; Corinne E Wessner; Rashmi Balasubramanya; Susan Dulka; Ji-Bin Liu; Priscilla Machado; Esika Savsani; Andrej Lyshchik; Colette M Shaw; John R Eisenbrey Journal: Abdom Radiol (NY) Date: 2021-10-13
Authors: Ali Morshid; Khaled M Elsayes; Ahmed M Khalaf; Mohab M Elmohr; Justin Yu; Ahmed O Kaseb; Manal Hassan; Armeen Mahvash; Zhihui Wang; John D Hazle; David Fuentes Journal: Radiol Artif Intell Date: 2019-09-25
Authors: Ji Hae Nahm; Hyungjin Rhee; Haeryoung Kim; Jeong Eun Yoo; Jee San Lee; Youngsic Jeon; Gi Hong Choi; Young Nyun Park Journal: Oncotarget Date: 2017-10-26