Validated preoperative computed tomography risk estimation for postoperative hepatocellular carcinoma recurrence

Abstract

AIMTo develop and validate a risk estimation of tumor recurrence following curative resection of operable hepatocellular carcinoma (HCC).METHODSData for 128 patients with operable HCC (according to Barcelona Clinic Liver Cancer imaging criteria) who underwent preoperative computed tomography (CT) evaluation at our hospital from May 1, 2013 through May 30, 2014 were included in this study. Follow-up data were obtained from hospital medical records. Follow-up data through May 30, 2016 were used to retrospectively analyze preoperative multiphasic CT findings, surgical histopathology results, and serum α-fetoprotein and thymidine kinase-1 levels. The χ2 test, independent t-test, and Mann-Whitney U test were used to analyze data. A P-value of < 0.05 was considered statistically significant.RESULTSDuring the follow-up period, 38 of 128 patients (29.7%) had a postoperative HCC recurrence. Microvascular invasion (MVI) was associated with HCC recurrence (χ2 = 13.253, P < 0.001). Despite postoperative antiviral therapy and chemotherapy, 22 of 44 patients with MVI experienced recurrence after surgical resection. The presence of MVI was 57.9% sensitive, 75.6% specific and 70.3% accurate in predicting postoperative recurrence. Of 84 tumors without MVI, univariate analysis confirmed that tumor margins, tumor margin grade, and tumor capsule detection on multiphasic CT were associated with HCC recurrence (P < 0.05). Univariate analyses showed no difference between groups with respect to hepatic capsular invasion, Ki-67 proliferation marker value, Edmondson-Steiner grade, largest tumor diameter, necrosis, arterial phase enhanced ratio, portovenous phase enhanced ratio, peritumoral enhancement, or serum α-fetoprotein level.CONCLUSIONNon-smooth tumor margins, incomplete tumor capsules and missing tumor capsules correlated with postoperative HCC recurrence. HCC recurrence following curative resection may be predicted using CT.

Preoperative computed tomography and serum α-fetoprotein to predict microvascular invasion in hepatocellular carcinoma

“…Tumor size was divided into 4 grades [ 21 ] : Grade 1 was 3 cm or less; Grade 2 was 3.1 to 5 cm; Grade 3 was 5.1 to 6.5 cm; and Grade 4 was greater than 6.5 cm. Tumor margins on the liver map (location on transverse, coronary, and sagittal planes) [ 3 , 8 , 22 , 23 ] were categorized using 3 subtypes (Fig. 1 ): smooth margins (simple nodular, frequently with a complete capsule); nonsmooth margins including focal extranodular type (single nodule outside the tumor capsule); and multinodular type (confluence of several small nodules).…”

Exosomes and Hepatocellular Carcinoma: From Bench to Bedside

“…The treatment options for advanced HCC are very limited, although there are several treatment options for HCC as follows: liver transplantation, surgical resection, RFA, TACE and systemic chemotherapy [13,18]. Moreover, the recurrence rate of HCC after surgical resection is 30–70% within 5 years [19,20,21].…”

Modification of the method to establish a hepatic VX2 carcinoma model in rabbits

“…The present study did not identify any significant differences in VEGF or CD31 levels between the two groups. Furthermore, CECT imaging of the two groups was consistent with the classic presentation of HCC (19). Hence, the inclusion of embedding sponge gelatin in the modified method does not appear to affect the blood supply of hepatic VX2 carcinoma at 14 days after surgery.…”