Observational Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jun 28, 2015; 7(12): 1694-1700
Published online Jun 28, 2015. doi: 10.4254/wjh.v7.i12.1694
Downstaging disease in patients with hepatocellular carcinoma outside up-to-seven criteria: Strategies using degradable starch microspheres transcatheter arterial chemo-embolization
Antonio Orlacchio, Fabrizio Chegai, Stefano Merolla, Simona Francioso, Costantino Del Giudice, Mario Angelico, Giuseppe Tisone, Giovanni Simonetti
Antonio Orlacchio, Fabrizio Chegai, Stefano Merolla, Costantino Del Giudice, Giovanni Simonetti, Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology, University Hospital Tor Vergata, 00133 Rome, Italy
Simona Francioso, Mario Angelico, Liver Unit, University Hospital Tor Vergata, 00133 Rome, Italy
Giuseppe Tisone, Organ Transplantation Unit, University Hospital Tor Vergata, 00133 Rome, Italy
Author contributions: Orlacchio A, Chegai F, Francioso S, Angelico M, Tisone G and Simonetti G designed research; Orlacchio A, Chegai F, Merolla S and Del Giudice C performed research; Orlacchio A, Chegai F, Merolla S and Francioso S contributed new reagents or analytic tools; Orlacchio A, Chegai F and Francioso S analyzed data; Orlacchio A, Chegai F and Francioso S wrote the paper.
Ethics approval: This study was approved by the Ethics Committee of our institution, No. 175/13.
Informed consent: All patients declared the informed consent.
Conflict-of-interest: All authors declare no conflict of interest.
Data sharing: Thecnical appendix, statistical code and data set available from the corresponding auhor at aorlacchio@uniroma2.it. The present data are anonymized without risk of identification.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Antonio Orlacchio, MD, Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology, University Hospital Tor Vergata, Viale Oxford 81, 00133 Rome, Italy. aorlacchio@uniroma2.it
Telephone: +39-6-20902400 Fax: +39-6-20902404
Received: November 28, 2014
Peer-review started: November 29, 2014
First decision: January 8, 2015
Revised: January 20, 2015
Accepted: May 26, 2015
Article in press: May 27, 2015
Published online: June 28, 2015
Core Tip

Core tip: Liver transplantation (LT) is the standard of care for select patients with hepatocellular carcinoma (HCC) and cirrhosis and recently more transplant centers use the new Milan criteria to assess the candidacy of HCC patients for LT. This manuscript reports a preliminary experience on the HCC treatment in liver transplant candidates without new-Milan-criteria, using a new technique of transcatheter arterial chemoembolization with degradable starch microspheres transcatheter arterial chemoembolization (DSM-TACE). Providing a temporary embolization DSM-TACE allows to treat more patients with an impaired liver function reducing toxicity due to standard arterial embolization. Moreover good down-staging rates after repeated DSM-TACE were successfully achieved.