Predictive factors of tumor response to trans-catheter treatment in cirrhotic patients with hepatocellular carcinoma: A multivariate analysis of pre-treatment findings

Abstract

AIM:To elucidate the pre-treatment clinical and imaging findings affecting the tumor response to the transcatheter treatment of unresectable hepatocellular carcinoma (HCC).

Safety and Efficacy of Transcatheter Arterial Chemoemboliazation in the Real-Life Management of Unresectable Hepatocellular Carcinoma

“…After multivariate analysis of alcohol abuse, lesion diameter, Child–Pugh classification, AFP level prior to the session and EASL classification were identified as independent prognostic factors of survival. Previous articles have already reported on the role of Child-Pugh classification, tumor size, AFP prior TACE and the proportion of tumor necrosis in the prediction of treatment response and survival (13, 21, 22). To the best of our knowledge, alcohol abuse has not been identified as an independent predictor of treatment response and survival in patients with unrespectable HCC.…”

CT and MR Imaging Diagnosis and Staging of Hepatocellular Carcinoma: Part I. Development, Growth, and Spread: Key Pathologic and Imaging Aspects

“…The precontrast image serves as a baseline to gauge subsequent enhancement. For observations that are hyperintense on precontrast MR images, subtraction images (postcontrast minus precontrast) may be helpful for detection of enhancement and evaluation of its degree (87). In theory, precontrast CT also might be helpful in patients with iron-rich nodules to detect hyperattenuation before contrast agent administration, thus avoiding misinterpretation of arterial-phase hyperenhancement, but there is little published evidence to our knowledge to support this benefit.…”

“…The late hepatic arterial phase is characterized by full enhancement of the hepatic artery and its branches as well as enhancement of the portal vein; the hepatic veins are not yet enhanced by antegrade flow (87). This phase coincides with peak arterial perfusion and enhancement of liver tumors, and it is critical for detection and characterization of hypervascular HCC (88) (Figs 2, 3).…”

The Kings Score refines prognostic prediction in hepatocellular carcinoma: a novel application

“…Serum AST levels are a marker of hepatocellular necrosis and can reflect both tumor burden as well as active damage stemming from the underlying cirrhotic liver . The presence of intratumoral hypoxia and necrosis, which often associate with a significant AST leak in the serum, are well known adverse prognostic hallmarks of HCC . Patient's age has emerged as a stage independent prognostic factor in HCC .…”