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Liver Imaging Reporting and Data System Category on Magnetic Resonance Imaging Predicts Recurrence of Hepatocellular Carcinoma After Liver Transplantation Within the Milan Criteria: A Multicenter Study

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Abstract
Background This study was designed to investigate the association between Liver Imaging Reporting and Data System (LI-RADS) category and recurrence of hepatocellular carcinoma (HCC) after primary liver transplantation (LT) within the Milan criteria. Methods This multicenter, retrospective study included 140 recipients who underwent living donor LT (LDLT) for treatment-naive HCC and pretransplant contrast-enhanced magnetic resonance imaging (MRI) between 2009 and 2013. LI-RADS categories were assigned using LI-RADS version 2018. Recurrence-free survival (RFS) and associated factors were evaluated using Cox proportional hazards regression analysis, Kaplan-Meier analysis, and log-rank test. Histological grading and microvascular invasion (MVI) were analyzed on the pathologic examinations of explanted livers. Results The overall 1-, 3-, 5-, and 7-year RFS rates were 95.6%, 92.6%, 90.2%, and 89.3%, respectively. In the multivariable analysis, independent predictors of recurrence included HCCs categorized as LR-M (hazard ratio [HR], 18.68; 95% confidence interval [CI], 5.79-60.23; P < 0.001) and the largest tumor size of >= 3 cm on MRI (HR, 4.18; 95% CI, 1.42-12.37; P = 0.010). The 5-year RFS rate was significantly lower in patients with HCCs categorized as LR-M than in those with HCCs categorized as LR-5 or 4 (LR-5/4) (36.9% vs. 95.8%, respectively; P < 0.001). HCCs categorized as LR-M exhibited significantly more MVI than HCCs categorized as LR-5/4 (57.1% vs. 17.5%, respectively; P = 0.002). Conclusions Patients with HCCs categorized as LR-M using LI-RADS version 2018 may have a worse prognosis after primary LT within the Milan criteria than those with HCCs categorized as LR-5/4.
Author(s)
이선영김경원정우경정소영황정아최진섭이승규조재원
Issued Date
2021
Type
Article
Keyword
DiseasesHepatobiliary TumorsHepatomaLiverMagnetic resonance imagingMedicineMedicine &amp; Public HealthOncologyPrognosisRelapseSurgerySurgical OncologyTransplantation
DOI
10.1245/s10434-021-09772-8
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7419
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2504352308&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Liver%20Imaging%20Reporting%20and%20Data%20System%20Category%20on%20Magnetic%20Resonance%20Imaging%20Predicts%20Recurrence%20of%20Hepatocellular%20Carcinoma%20After%20Liver%20Transplantation%20Within%20the%20Milan%20Criteria:%20A%20Multicenter%20Study&amp;offset=0&amp;pcAvailability=true
Publisher
ANNALS OF SURGICAL ONCOLOGY
Location
미국
Language
한국어
ISSN
1068-9265
Citation Volume
28
Citation Number
11
Citation Start Page
6782
Citation End Page
6789
Appears in Collections:
Medicine > Medicine
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