Imaging Predictors of Survival in Patients with Single Small Hepatocellular Carcinoma Treated with Transarterial Chemoembolization
- 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)
- 권동일; 김동준; 김소연; 김진영; 김진형; 김평화; 박민호; 박찬; 추희호; 허준호
- Issued Date
- 2021
- Type
- Article
- Keyword
- Aged; Area Under Curve; Hepatocellular - diagnostic imaging; Hepatocellular - mortality; Hepatocellular - therapy; Therapeutic; Computed tomography imaging; Female; Hepatocellular carcinoma; Humans; Intervention; Kaplan-Meier Estimate; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - mortality; Liver Neoplasms - therapy; Magnetic Resonance Imaging; Male; Middle Aged; Prognosis; Progression-Free Survival; Proportional Hazards Models; Retrospective Studies; ROC Curve; Survival; X-Ray Computed; Transarterial chemoembolization; Treatment Outcome; 방사선과학
- DOI
- 10.3348/kjr.2020.0325
- URI
- https://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&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Imaging%20Predictors%20of%20Survival%20in%20Patients%20with%20Single%20Small%20Hepatocellular%20Carcinoma%20Treated%20with%20Transarterial%20Chemoembolization&offset=0&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
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