BACKGROUND AND AIM: The aim of our study was to determine the predictors of recurrences in hepatocellular carcinoma (HCC) patients who had achieved complete remission (CR) by transarterial chemoembolization (TACE). METHODS: A total of 220 consecutive HCC patients who had achieved CR by TACE were followed for a median 72 months. CR was defined as complete lipiodol uptake based on the results of lipiodol-computed tomography 4 weeks after TACE and no additional tumor staining on the follow-up angiography. Recurrence patterns were classified as local recurrence and secondary tumor, respectively, in relation to the location of recurrence; early and late recurrence were classified in relation to recurrence time. RESULTS: Recurrence of HCC was observed in 169 patients (77 %), of whom 91 (54 %) had local recurrences, 61 (36 %) had secondary tumor, and 17 (10 %) had both. There were 45 (27 %) early and 124 (73 %) late recurrences. Local recurrence developed more frequently in patients with early recurrence than in those with late recurrence (62 vs. 51 %, respectively), while secondary tumor was detected more commonly in patients with late recurrence than in those with early recurrence (39 vs. 29 %, respectively; P < 0.001). In multivariate analyses, multinodularity [hazard ratio (HR) 2.351, P = 0.023] and a persistently high serum alpha-fetoprotein level following CR (HR 3.173, P < 0.001) were significant predictors of early recurrence. Older age (≥ 60 years; HR 1.531, P = 0.043), advanced Child-Pugh class (HR 1.983, P = 0.002), and the association with cirrhosis (HR 1.756, P = 0.028) were predictors of late recurrence following CR. CONCLUSIONS: Early recurrences following CR by TACE may be due mainly to undetectable remaining tumors, whereas late recurrences may be caused by newly appearing tumors in patients with a background of advanced cirrhotic liver.
BACKGROUND AND AIM: The aim of our study was to determine the predictors of recurrences in hepatocellular carcinoma (HCC) patients who had achieved complete remission (CR) by transarterial chemoembolization (TACE). METHODS: A total of 220 consecutive HCC patients who had achieved CR by TACE were followed for a median 72 months. CR was defined as complete lipiodol uptake based on the results of lipiodol-computed tomography 4 weeks after TACE and no additional tumor staining on the follow-up angiography. Recurrence patterns were classified as local recurrence and secondary tumor, respectively, in relation to the location of recurrence; early and late recurrence were classified in relation to recurrence time. RESULTS: Recurrence of HCC was observed in 169 patients (77 %), of whom 91 (54 %) had local recurrences, 61 (36 %) had secondary tumor, and 17 (10 %) had both. There were 45 (27 %) early and 124 (73 %) late recurrences. Local recurrence developed more frequently in patients with early recurrence than in those with late recurrence (62 vs. 51 %, respectively), while secondary tumor was detected more commonly in patients with late recurrence than in those with early recurrence (39 vs. 29 %, respectively; P < 0.001). In multivariate analyses, multinodularity [hazard ratio (HR) 2.351, P = 0.023] and a persistently high serum alpha-fetoprotein level following CR (HR 3.173, P < 0.001) were significant predictors of early recurrence. Older age (≥ 60 years; HR 1.531, P = 0.043), advanced Child-Pugh class (HR 1.983, P = 0.002), and the association with cirrhosis (HR 1.756, P = 0.028) were predictors of late recurrence following CR. CONCLUSIONS: Early recurrences following CR by TACE may be due mainly to undetectable remaining tumors, whereas late recurrences may be caused by newly appearing tumors in patients with a background of advanced cirrhotic liver.
Authors: Nicholas R Perkons; Ryan M Kiefer; Michael C Noji; Mehrdad Pourfathi; Daniel Ackerman; Sarmad Siddiqui; David Tischfield; Enri Profka; Omar Johnson; Stephen Pickup; Anthony Mancuso; Austin Pantel; Michelle R Denburg; Gregory J Nadolski; Stephen J Hunt; Emma E Furth; Stephen Kadlecek; Terence P F Gade Journal: Hepatology Date: 2020-05-16 Impact factor: 17.425
Authors: Terence P F Gade; Elizabeth Tucker; Michael S Nakazawa; Stephen J Hunt; Waihay Wong; Bryan Krock; Charles N Weber; Gregory J Nadolski; Timothy W I Clark; Michael C Soulen; Emma E Furth; Jeffrey D Winkler; Ravi K Amaravadi; M Celeste Simon Journal: Radiology Date: 2017-03-02 Impact factor: 11.105
Authors: David J Tischfield; Alexey Gurevich; Omar Johnson; Isabela Gatmaytan; Gregory J Nadolski; Michael C Soulen; David E Kaplan; Emma Furth; Stephen J Hunt; Terence P F Gade Journal: Radiology Date: 2022-01-11 Impact factor: 29.146
Authors: Andrea C Cortes; Hideyuki Nishiofuku; Urszula Polak; Adeeb A Minhaj; Mirtha S Lopez; Kimihiko Kichikawa; Aliya Qayyum; Elizabeth M Whitley; Rony Avritscher Journal: Nanomedicine Date: 2021-09-24 Impact factor: 6.096