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Computed tomography during hepatic arteriography pattern may predict hepatocellular carcinoma recurrence following transarterial chemoembolization
Author(s) -
Katayama Kazuhiro,
Ohkawa Kazuyoshi,
Imanaka Kazuho,
Sakakibara Mitsuru,
Miyazaki Masanori,
Kimura Haruki,
Ishihara Akio,
Matsunaga Takashi,
Murata Masayuki,
Nakazawa Tetsuro,
Nakanishi Katsuyuki
Publication year - 2014
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12337
Subject(s) - hepatocellular carcinoma , medicine , lipiodol , gastroenterology , radiology , proportional hazards model , univariate analysis , carcinoma , nuclear medicine , multivariate analysis
Aim This study aimed to determine the role of morphological patterns seen on imaging in predicting hepatocellular carcinoma recurrence following transarterial chemoembolization therapy. Methods Forty‐seven patients from a single center who underwent transarterial chemoembolization to treat unresectable hepatocellular carcinomas between J anuary 2011 and J une 2012 were included in this study. We investigated whether the two pretreatment findings on computed tomography during hepatic arteriography (pattern 1, the single nodule pattern; pattern 2, at least one nodule showing the contiguous multinodular pattern) and other factors (age, sex, etiology, serum total bilirubin, serum albumin, prothrombin time, platelet count, serum level of protein induced by vitamin K absence/antagonist‐ II , serum α‐fetoprotein, number of previous treatments for hepatocellular carcinoma, tumor number and maximum tumor size, presence of hypovascular lesions) could predict post‐treatment recurrence. Results In a univariate analysis using C ox's proportional hazards model, serum total bilirubin, the serum level of protein induced by vitamin K absence/antagonist‐ II (≤100 vs ≥101 mAU/mL), tumor morphology (pattern 1 vs 2) and tumor number (≤3 vs ≥4) showed statistical significance (≤0.05). In a multivariate analysis of these factors, morphology and tumor number showed significance. According to K aplan– M eier estimation, the cumulative disease‐free survival rates were significantly lower in patients with four or more lesions than in those with three or less lesions and in patients showing pattern 2 than in those showing pattern 1. Conclusion Patients with pattern 2 hepatocellular carcinoma and/or four or more lesions may have a relatively high recurrence rate after transarterial chemoembolization.