Prognostic implications of tumor vascularity and its relationship to cytokeratin 19 expression in patients with hepatocellular carcinoma

Chung, Gyung Ho; Lee, Jeong-Hoon; Yoon, Jeesun; Myung, Sun Jung; Lee, Kyuho; Jang, Ja June; Kim, Se Hyung; Suh, Kyung‐Suk; Kim, Yoon Jun; Lee, Hyo Suk

doi:10.1007/s00261-011-9756-3

Cited by 20 publications

(12 citation statements)

References 30 publications

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“…Studies investigating tumor vascularity as a factor impacting treatment outcome after TACE showed that high serum VEGF levels were significantly correlated with poor outcomes after TACE [ 30 ]. However, other studies showed that patients with hypovascular HCC had a poorer response, poorer survival, and early recurrence compared to patients with hypervascular tumors [ 3 , 18 , 20 , 21 ], possibly because the chemotherapeutic agent or embolic agent is more efficiently delivered to tumors with a good arterial supply. These data suggested that the role of tumor vascularity in treatment response and OS is not completely understood.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, TACE was found to be as effective as hepatic resection when lipiodol was compactly retained within the tumor [ 17 ]. Additionally, patients with well-differentiated, hypovascular HCC tumors responded poorly to TACE, had a shorter OS, and were associated with early recurrence compared to patients with well-differentiated hypervascular tumors [ 18 , 19 , 20 , 21 ]. However, in patients with unresectable HCC treated with TACE, OS was higher in hypervascular responders, and in hypervascular non-responders and hypovascular responders compared to hypovascular non-responders [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Tumor vascularity and lipiodol deposition as early radiological markers for predicting risk of disease progression in patients with unresectable hepatocellular carcinoma after transarterial chemoembolization

Chen

Guo

et al. 2016

Oncotarget

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This study evaluated the factors impacting overall survival (OS) and time to progression (TTP) in patients with unresectable hepatocellular carcinoma (HCC) who received transarterial chemoembolization (TACE). HCC patients were grouped based on tumor vascularity and lipidiol deposition after TACE. Tumor vascularity was classified based on contrast enhancement on arterial phase baseline CT scans. Lipiodol deposition was evaluated using CT scans. The progression-free rate was significantly higher in patients with good blood supply + good lipiodol deposition compared to those with good blood supply + poor lipiodol deposition. In patients with poor lipidiol deposition, risk of death was significantly positively correlated with stage, and negatively correlated with number of TACE procedures and degree of lipidiol deposition after the first TACE. Risk of disease progression in these patients was positively correlated with tumor size, and negatively correlated with number of TACE procedures and degree of lipidiol deposition after the first TACE. Our data showed that tumor vascularity and lipiodol deposition can be used as early radiological markers to identify patients who do not respond to TACE, and who can be considered earlier for alternative combination treatment strategies. Our data also indicated that poor lipiodol retention may predict a poor TTP and OS despite the blood supply status.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Tumor vascularity and lipiodol deposition as early radiological markers for predicting risk of disease progression in patients with unresectable hepatocellular carcinoma after transarterial chemoembolization

Chen

Guo

et al. 2016

Oncotarget

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“…In fact, in subjects with HCC, k19 expression showed a correlation not only with morphological tumor parameters (increased tumor size, poor grade differentiation, microvascular invasion) in both surgical specimens and in samples obtained by fine needle biopsy [100,107] but also with overall survival and recurrence rate [100,107] . Furthermore, CT scans have shown that k19 was more frequently expressed in hypovascular HCCs, indicating a major risk of early recurrence [108] .…”

Section: Liver Biopsy (Percutaneous and Surgical Biopsy)mentioning

confidence: 99%

Prognostic factors for hepatocellular carcinoma recurrence

Colecchia

Schiumerini

Cucchetti

et al. 2014

WJG

144

121

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The recurrence of hepatocellular carcinoma, the sixth most common neoplasm and the third leading cause of cancer-related mortality worldwide, represents an important clinical problem, since it may occur after both surgical and medical treatment. The recurrence rate involves 2 phases: an early phase and a late phase. The early phase usually occurs within 2 years after resection; it is mainly related to local invasion and intrahepatic metastases and, therefore, to the intrinsic biology of the tumor. On the other hand, the late phase occurs more than 2 years after surgery and is mainly related to de novo tumor formation as a consequence of the carcinogenic cirrhotic environment. Since recent studies have reported that early and late recurrences may have different risk factors, it is clinically important to recognize these factors in the individual patient as soon as possible. The aim of this review was, therefore, to identify predicting factors for the recurrence of hepatocellular carcinoma, by means of invasive and non-invasive methods, according to the different therapeutic strategies available. In particular the role of emerging techniques (e.g., transient elastography) and biological features of hepatocellular carcinoma in predicting recurrence have been discussed. In particular, invasive methods were differentiated from non-invasive ones for research purposes, taking into consideration the emerging role of the genetic signature of hepatocellular carcinoma in order to better allocate treatment strategies and surveillance follow-up in patients with this type of tumor.

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“…After further reading the fulltext, 8 articles were excluded due to duplication (n = 6), HR with 95% CI unavailable (n = 1) and scoring less than 6 (n = 1) [15]. Eventually, there were 17 studies included in this present meta-analysis [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] (Fig. 1).…”

Section: Literature Search Informationmentioning

confidence: 99%

Prognostic value of cytokeratin 19 in hepatocellular carcinoma: A meta-analysis

Sun

Zhang

Sun

et al. 2015

Clinica Chimica Acta

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Prognostic implications of tumor vascularity and its relationship to cytokeratin 19 expression in patients with hepatocellular carcinoma

Abstract: Hypovascular HCCs were associated with early recurrence and short overall survival, and CK19 was more frequently expressed in hypovascular HCC than in hypervascular tumors. Therefore, tumor vascularity on CT images might be utilized in determining the prognosis of patients with HCCs.

Cited by 20 publications

References 30 publications

Tumor vascularity and lipiodol deposition as early radiological markers for predicting risk of disease progression in patients with unresectable hepatocellular carcinoma after transarterial chemoembolization

Tumor vascularity and lipiodol deposition as early radiological markers for predicting risk of disease progression in patients with unresectable hepatocellular carcinoma after transarterial chemoembolization

Prognostic factors for hepatocellular carcinoma recurrence

Prognostic value of cytokeratin 19 in hepatocellular carcinoma: A meta-analysis

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