Local recurrence following complete radiologic response in patients treated with transarterial chemoembolization for hepatocellular carcinoma

Young, Shamar; Sanghvi, Tina; Sharma, Sandeep; Richardson, Cameron; Rubin, Nathan; Richards, M.; D’Souza, Donna; Flanagan, Siobhan; Golzarian, Jafar

doi:10.1016/j.diii.2022.01.006

Cited by 17 publications

(7 citation statements)

References 27 publications

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“…Second, an exhaustive radio-pathological correlation could not be investigated because of the retrospective methodology of the pathologic evaluation and the nonavailability of liver explants during the study period. Third, the heterogeneity of IAT performed using different approaches (DT/BT) may be another limitation to understanding the specific prognostic impact of HVI regarding their different histological effects [50][51][52][53]. Zori et al [47], through a series of 65 liver-transplanted patients, showed a significantly lower rate of microvascular invasion in the group treated by TARE as a BT compared with the TACE-treated patient group.…”

Section: Discussionmentioning

confidence: 99%

Should Hypervascular Incidentalomas Detected on Per-Interventional Cone Beam Computed Tomography during Intra-Arterial Therapies for Hepatocellular Carcinoma Impact the Treatment Plan in Patients Waiting for Liver Transplantation?

Derbel,

Galletto Pregliasco,

Mulé

et al. 2024

Cancers

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Background: Current guidelines do not indicate any comprehensive management of hepatic hypervascular incidentalomas (HVIs) discovered in hepatocellular carcinoma (HCC) patients during intra-arterial therapies (IATs). This study aims to evaluate the prognostic value of HVIs detected on per-interventional cone beam computed tomography (CBCT) during IAT for HCC in patients waiting for liver transplantation (LT). Material and methods: In this retrospective single-institutional study, all liver-transplanted HCC patients between January 2014 and December 2018 who received transarterial chemoembolization (TACE) or radioembolization (TARE) before LT were included. The number of ≥10 mm HCCs diagnosed on contrast-enhanced pre-interventional imaging (PII) was compared with that detected on per-interventional CBCT with a nonparametric Wilcoxon test. The correlation between the presence of an HVI and histopathological criteria associated with poor prognosis (HPP) on liver explants was investigated using the chi-square test. Tumor recurrence (TR) and TR-related mortality were investigated using the chi-square test. Recurrence-free survival (RFS), TR-related survival (TRRS), and overall survival (OS) were assessed according to the presence of HVI using Kaplan–Meier analysis. Results: Among 63 included patients (average age: 59 ± 7 years, H/F = 50/13), 36 presented HVIs on per-interventional CBCT. The overall nodule detection rate of per-interventional CBCT was superior to that of PII (median at 3 [Q1:2, Q3:5] vs. 2 [Q1:1, Q3:3], respectively, p < 0.001). No significant correlation was shown between the presence of HVI and HPP (p = 0.34), TR (p = 0.095), and TR-related mortality (0.22). Kaplan–Meier analysis did not show a significant impact of the presence of HVI on RFS (p = 0.07), TRRS (0.48), or OS (p = 0.14). Conclusions: These results may indicate that the treatment plan during IAT should not be impacted or modified in response to HVI detection.

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Section: Discussionmentioning

confidence: 99%

Should Hypervascular Incidentalomas Detected on Per-Interventional Cone Beam Computed Tomography during Intra-Arterial Therapies for Hepatocellular Carcinoma Impact the Treatment Plan in Patients Waiting for Liver Transplantation?

Derbel,

Galletto Pregliasco,

Mulé

et al. 2024

Cancers

View full text Add to dashboard Cite

show abstract

“…Second, an exhaustive radio-pathological correlation could not be investigated because of the retrospective methodology of the pathologic evaluation and the nonavailability of liver explants during the study period. Third, the heterogeneity of IAT performed using different approaches (DT/BT) may be another limitation to understanding the speci c prognostic impact of HVI regarding their different histological effects (51)(52)(53)(54). Zori et al (48), through a series of 65 liver-transplanted patients, showed a signi cantly lower rate of microvascular invasion in the group treated by TARE as a BT compared to the TACE-treated patient group.…”

Section: Discussionmentioning

confidence: 99%

Should hypervascular incidentalomas detected on per-interventional cone beam computed tomography during intra-arterial therapies for hepatocellular carcinoma impact the treatment plan in patients waiting for liver transplantation?

Derbel,

Galletto,

Mulé

et al. 2023

Preprint

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Background and objective Current guidelines do not indicate any comprehensive management of hepatic hypervascular incidentalomas (HVIs) discovered in hepatocellular carcinoma (HCC) patients during intra-arterial therapies (IAT). The objective of this study is to evaluate the prognostic value of HVIs detected on per-interventional cone beam computed tomography (CBCT) during IAT for HCC in patients waiting for liver transplantation (LT). Material and methods In this retrospective single-institutional study, all liver-transplanted HCC patients between January 2014 and December 2018 who received transarterial chemoembolization (TACE) or radioembolization (TARE) before LT were included. The number of ≥ 10 mm HCCs diagnosed on contrast-enhanced preinterventional imaging (PII) was compared to that detected on per-interventional CBCT with a nonparametric Wilcoxon test. The correlation between the presence of an HVI and histopathological criteria associated with poor prognosis (HPP) on liver explants was investigated using the chi-square test. Tumor recurrence (TR) and TR-related mortality were investigated using the chi-square test. Recurrence-free survival (RFS), TR-related survival (TRRS), and overall survival (OS) were assessed according to the presence of HVI using Kaplan‒Meier analysis. Results Among 63 included patients (average age: 59 ± 7 years, H/F = 50/13), 36 presented HVIs on per-interventional CBCT. The overall nodule detection rate of per-interventional CBCT was superior to that of PII (median at 3 [Q1:2, Q3:5] vs. 2 [Q1:1, Q3:3], respectively, p < 0.001). No significant correlation was shown between the presence of HVI and HPP (p = 0.34), TR (p = 0.095) and TR-related mortality (0.22). Kaplan‒Meier analysis did not show a significant impact of the presence of HVI on RFS (p = 0.07), TRRS (0.48), or OS (p = 0.14). Conclusion Detection of HVIs during IAT should not affect the IAT treatment plan in patients awaiting LT.

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“…There is ample research available focusing on potential imaging biomarkers in the early postinterventional period to predict overall survival (OS) and progression free survival (PFS) [ [14] , [15] , [16] , [17] , [18] , [19] , [20] , [26] , [27] ]. With all these methods, however, TARE (or Transarterial Chemoembolization) has already been performed by the time when a statement can be made if the treatment was likely to be successful or not.…”

Section: Discussionmentioning

confidence: 99%

Quantitative and qualitative evaluation of liver metastases with intraprocedural cone beam CT prior to transarterial radioembolization as a predictor of treatment response

Messmer

Zgraggen

Kobe

et al. 2022

Research in Diagnostic and Interventional Imaging

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Local recurrence following complete radiologic response in patients treated with transarterial chemoembolization for hepatocellular carcinoma

Cited by 17 publications

References 27 publications

Should Hypervascular Incidentalomas Detected on Per-Interventional Cone Beam Computed Tomography during Intra-Arterial Therapies for Hepatocellular Carcinoma Impact the Treatment Plan in Patients Waiting for Liver Transplantation?

Should Hypervascular Incidentalomas Detected on Per-Interventional Cone Beam Computed Tomography during Intra-Arterial Therapies for Hepatocellular Carcinoma Impact the Treatment Plan in Patients Waiting for Liver Transplantation?

Should hypervascular incidentalomas detected on per-interventional cone beam computed tomography during intra-arterial therapies for hepatocellular carcinoma impact the treatment plan in patients waiting for liver transplantation?

Quantitative and qualitative evaluation of liver metastases with intraprocedural cone beam CT prior to transarterial radioembolization as a predictor of treatment response

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