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Imaging Predictors of Survival in Patients with Single Small Hepatocellular Carcinoma Treated with Transarterial Chemoembolization

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Abstract
Objective: Clinical outcomes of patients who undergo transarterial chemoembolization (TACE) for single small hepatocellular carcinoma (HCC) are not consistent, and may differ based on certain imaging findings. This retrospective study was aimed at determining the efficacy of pre-TACE CT or MR imaging findings in predicting survival outcomes in patients with small HCC upon being treated with TACE. Besides, the study proposed to build a risk prediction model for these patients.

Materials and Methods: Altogether, 750 patients with functionally good hepatic reserve who received TACE as the first-line treatment for single small HCC between 2004 and 2014 were included in the study. These patients were randomly assigned into training (n = 525) and validation (n = 225) sets.

Results: According to the results of a multivariable Cox analysis, three pre-TACE imaging findings (tumor margin, tumor location, enhancement pattern) and two clinical factors (age, serum albumin level) were selected and scored to create predictive models for overall, local tumor progression (LTP)-free, and progression-free survival in the training set. The median overall survival time in the validation set were 137.5 months, 76.1 months, and 44.0 months for low-, intermediate-, and high-risk groups, respectively (p < 0.001). Time-dependent receiver operating characteristic curves of the predictive models for overall, LTP-free, and progression-free survival applied to the validation cohort showed acceptable areas under the curve values (0.734, 0.802, and 0.775 for overall survival; 0.738, 0.789, and 0.791 for LTP-free survival; and 0.671, 0.733, and 0.694 for progression-free survival at 3, 5, and 10 years, respectively).

Conclusion: Pre-TACE CT or MR imaging findings could predict survival outcomes in patients with small HCC upon treatment with TACE. Our predictive models including three imaging predictors could be helpful in prognostication, identification, and selection of suitable candidates for TACE in patients with single small HCC.
Author(s)
권동일김동준김소연김진영김진형김평화박민호박찬추희호허준호
Issued Date
2021
Type
Article
Keyword
AgedArea Under CurveHepatocellular - diagnostic imagingHepatocellular - mortalityHepatocellular - therapyTherapeuticComputed tomography imagingFemaleHepatocellular carcinomaHumansInterventionKaplan-Meier EstimateLiver Neoplasms - diagnostic imagingLiver Neoplasms - mortalityLiver Neoplasms - therapyMagnetic Resonance ImagingMaleMiddle AgedPrognosisProgression-Free SurvivalProportional Hazards ModelsRetrospective StudiesROC CurveSurvivalX-Ray ComputedTransarterial chemoembolizationTreatment Outcome방사선과학
DOI
10.3348/kjr.2020.0325
URI
http://oak.ulsan.ac.kr/handle/2021.oak/7785
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_nrf_kci_oai_kci_go_kr_ARTI_9699032&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,Imaging%20Predictors%20of%20Survival%20in%20Patients%20with%20Single%20Small%20Hepatocellular%20Carcinoma%20Treated%20with%20Transarterial%20Chemoembolization&amp;offset=0&amp;pcAvailability=true
Publisher
KOREAN JOURNAL OF RADIOLOGY
Location
대한민국
Language
영어
ISSN
1229-6929
Citation Volume
22
Citation Number
2
Citation Start Page
213
Citation End Page
224
Appears in Collections:
Medicine > Medicine
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