Histopathologic correlation of hepatocellular carcinoma after transcatheter arterial chemoembolization with polyvinyl alcohol particle of various sizes

Abstract

AimTranscatheter arterial chemoembolization (TACE) is one of major treatment for unresectable hepatocellular carcinomas (HCC) and has been used as a neoadjuvant treatment before surgery. This study was to describe the histopathologic features of HCC after TACE with variously sized polyvinyl alcohol (PVA) particles. Materials and methodsSeventeen patients undergoing TACE with PVA followed by surgery for HCC were analyzed. The PVA particles used in TACE were categorized into two groups in respects of particle sizes: the group I, 47–90μm (n=8) and the group II, >90–250μm (n=9). The histopathologic features of the resected HCC were characterized with the emphasis on the number of thrombosed vessels and minimal diameter of arterioles/capillaries containing polyvinyl alcohol particles. The clinical results after TACE were also addressed. ResultsHistopathologic examinations showed that the median minimal diameters of arterioles containing PVA particles were 0.035mm in group I and 0.06mm in group II (p=0.0078). We observed the PVA particle in the sinusoidal spaces of non-tumourous liver in only one patient. However, no sinusoidal infarction was demonstrated in either group. Mean tumour necrosis rate was 67% vs. 61% for the group I and II, respectively. ConclusionsThe smaller PVA particles can reach and occlude more distal arteriolar capillaries, but rarely leak into non-tumourous hepatic sinusoidal spaces. Slightly better tumour necrosis rate after TACE can be achieved.