Jae Seok Bae1,2, Jung Hoon Kim3,4,5, Dong Ho Lee1,2, Jae Hyun Kim1,2, Joon Koo Han1,2,6. 1. Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. 2. Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. 3. Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. jhkim2008@gmail.com. 4. Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. jhkim2008@gmail.com. 5. Department of Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. jhkim2008@gmail.com. 6. Department of Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Abstract
OBJECTIVES: Patients with hepatocellular carcinoma (HCC) receiving different treatments might have specific prognostic factors that can be captured in the hepatobiliary phase (HBP) of gadoxetic acid-enhanced magnetic resonance imaging (GA-MRI). We aimed to identify the clinical findings and HBP features with prognostic value in patients with HCC. METHODS: In this retrospective, single-institution study, we included patients with Barcelona Clinic Liver Cancer very early/early stage HCC who underwent GA-MRI before treatment. After performing propensity score matching, 183 patients received the following treatments: resection, radiofrequency ablation (RFA), and transarterial chemoembolization (TACE) (n = 61 for each). Cox regression models were used to identify clinical factors and HBP features associated with disease-free survival (DFS) and overall survival (OS). RESULTS: In the resection group, large tumor size was associated with poor DFS (hazard ratio [HR] 4.159 per centimeter; 95% confidence interval [CI], 1.669-10.365) and poor OS (HR 8.498 per centimeter; 95% CI, 1.072-67.338). In the RFA group, satellite nodules on HBP images were associated with poor DFS (HR 5.037; 95% CI, 1.061-23.903) and poor OS (HR 9.398; 95% CI, 1.480-59.668). Peritumoral hypointensity on HBP images was also associated with poor OS (HR 13.062; 95% CI, 1.627-104.840). In addition, serum albumin levels and the prothrombin time-international normalized ratio were associated with DFS and/or OS. Finally, in the TACE group, no variables were associated with DFS/OS. CONCLUSIONS: Different HBP features and clinical factors were associated with DFS/OS among patients with HCC receiving different treatments. KEY POINTS: • In patients who underwent resection for HCC, a large tumor size on HBP images was associated with poor disease-free survival and overall survival. • In the RFA group, satellite nodules and peritumoral hypointensity on HBP images, along with decreased serum albumin levels and PT-INR, were associated with poor disease-free survival and/or overall survival. • In the TACE group, no clinical or HBP imaging features were associated with disease-free survival or overall survival.
OBJECTIVES:Patients with hepatocellular carcinoma (HCC) receiving different treatments might have specific prognostic factors that can be captured in the hepatobiliary phase (HBP) of gadoxetic acid-enhanced magnetic resonance imaging (GA-MRI). We aimed to identify the clinical findings and HBP features with prognostic value in patients with HCC. METHODS: In this retrospective, single-institution study, we included patients with Barcelona Clinic Liver Cancer very early/early stage HCC who underwent GA-MRI before treatment. After performing propensity score matching, 183 patients received the following treatments: resection, radiofrequency ablation (RFA), and transarterial chemoembolization (TACE) (n = 61 for each). Cox regression models were used to identify clinical factors and HBP features associated with disease-free survival (DFS) and overall survival (OS). RESULTS: In the resection group, large tumor size was associated with poor DFS (hazard ratio [HR] 4.159 per centimeter; 95% confidence interval [CI], 1.669-10.365) and poor OS (HR 8.498 per centimeter; 95% CI, 1.072-67.338). In the RFA group, satellite nodules on HBP images were associated with poor DFS (HR 5.037; 95% CI, 1.061-23.903) and poor OS (HR 9.398; 95% CI, 1.480-59.668). Peritumoral hypointensity on HBP images was also associated with poor OS (HR 13.062; 95% CI, 1.627-104.840). In addition, serum albumin levels and the prothrombin time-international normalized ratio were associated with DFS and/or OS. Finally, in the TACE group, no variables were associated with DFS/OS. CONCLUSIONS: Different HBP features and clinical factors were associated with DFS/OS among patients with HCC receiving different treatments. KEY POINTS: • In patients who underwent resection for HCC, a large tumor size on HBP images was associated with poor disease-free survival and overall survival. • In the RFA group, satellite nodules and peritumoral hypointensity on HBP images, along with decreased serum albumin levels and PT-INR, were associated with poor disease-free survival and/or overall survival. • In the TACE group, no clinical or HBP imaging features were associated with disease-free survival or overall survival.
Entities:
Keywords:
Carcinoma, hepatocellular; Gadolinium DTPA; Magnetic resonance imaging; Prognosis; Treatment