5%, P = 0.255). Details regarding the course of liver laboratory tests after TACE are reported in Table 2. Clinical

and tumor characteristics with respect to lobar and Autophagy phosphorylation selective/superselective TACE are reported in Table 3: as expected, the choice of the procedure was affected by the presence of multinodular tumors, but it was unaffected by liver function status, although a minimal trend toward worse liver function in those treated with selective/superselective TACE emerged. Patients who underwent selective/superselective TACE required fewer repeat procedures than patients who underwent lobar TACE [12 of 38 (31.6%) versus 16 of 27 (59.3%), P = 0.0049] because residual vital tumors were less common. One of the two patients who received the combination of techniques required one additional treatment. Because the type of TACE performed in each patient was affected by the number of tumors and the stage, an analysis of the histological outcome was carried out Metformin in vitro for each individual nodule. At the beginning of the observation period, 122 nodules were identified; 53.3% (65 cases) were treated with selective/superselective TACE, whereas the remaining 46.7% were treated with a lobar procedure (57 cases). The characteristics of the treated nodules with respect to the adopted procedures are reported in Table 4; the diameters of the nodules treated with selective/superselective

and lobar TACE were similar (P = 0.725), but as expected, multiple tumors were

more frequently treated with lobar TACE (P = 0.041). In the explanted Florfenicol liver, the mean treated tumor necrosis level was 64.7%; complete tumor necrosis was obtained in 42.6% (52 cases), whereas the remaining proportion showed different degrees of necrosis. Tumor necrosis was affected by the adopted procedure; it was greater after selective/superselective TACE (75.1%) versus lobar TACE (52.8%, P = 0.002) whether all the nodules were considered as a whole or the nodules were subgrouped according to their size (Table 4). Complete necrosis and necrosis ≥ 90% were more frequently observed after selective/superselective TACE versus lobar TACE (P = 0.013 and P = 0.008, respectively). The treatment of patients with single nodules led to higher levels of tumor necrosis (mean = 86.1%) than the treatment of patients with multiple nodules (57.1%, P = 0.001). The differences between the treatment modalities (selective TACE was better than lobar TACE) were more evident for multiple nodules (P = 0.029; Table 4) than for single nodules (P = 0.172; Table 4). A significant direct relationship between necrosis and the tumor diameter was found, regardless of the type of TACE procedure, in our series of small HCCs: the greater the tumor diameter, the greater the percentage of necrosis. The mean necrosis levels were 59.6% for nodules ≤ 2 cm, 68.4% for nodules of 2.1 to 3.0 cm, and 76.2% for nodules > 3.1 cm (P = 0.038; Table 4).