Article Sidebar
Views pdf: 44
PRE-OPERATIVE COMPUTED TOMOGRAPHY TO PREDICT EARLY RECURRENCE OF HEPATOCELLULAR CARCINOMA AFTER SURGICAL RESECTION
Main Article Content
Abstract
Background: Hepatocellular carcinoma (HCC) is one of the leading causes of death related to cancer in Vietnam. The tumor recurrence rate after surgical resection remains considerably high. Predicting a patient at high risk of early recurrence (ER) may provide additional information for planning treatment strategies and post-operative follow-up. Objective: To evaluate the value of pre-operative computed tomography (CT) features and develop a model to predict ER (≤ 2 years) of HCC after surgical resection. Methods: A retrospective cohort study was conducted from January 2018 to December 2020 to include HCC patients who underwent hepatectomy and followed up at University Medical Center, Ho Chi Minh City. Clinical factors, recurrence status, pathological characteristics, blood tests, surgical factors, and pre-operative CT imaging traits were evaluated. A predictive model was built based on multivariable logistic regression analysis. Results: A total of 201 HCC patients were enrolled and divided into ER group (n = 79) and non-ER group (n = 122). The rate of ER was 39.3%. The mean time to recurrence was 10 ± 6 months. Univariable analyses showed that Child–Pugh grade, BCLC stage, SGOT and SGPT, major liver resection, tumor size, incomplete capsule, tumor necrosis, internal arteries, macrovascular invasion, satellite nodules, and corona enhancement were significantly associated with ER. Multivariable analyses showed that all independent risk factors of ER were pre-operative CT features: incomplete capsule (OR = 4.0), internal arteries (OR = 3.1), macrovascular invasion (OR = 8.2), satellite nodules (OR = 10.2), and corona enhancement (OR = 3.3). The predictive model combined of those five imaging traits presented good performance in the discrimination of ER with an AUC of 0.821 (95% CI: 0.759–0.882), sensitivity of 65.8%, specificity of 91.8%, and accuracy of 81.6%. Conclusions: CT scan is a valuable imaging modality that performs well in predicting ER of HCC, and can be utilized to stratify patients pre-operatively.
Article Details
Keywords
hepatocellular carcinoma, computed tomography, predictor, early recurrence
References
2. Tung-Ping Poon, R., S.T. Fan, and J. Wong (2000), Risk factors, prevention, and management of postoperative recurrence after resection of hepatocellular carcinoma. Ann Surg. 232(1):10-24.
3. Poon, R.T., et al. (2000), Different risk factors and prognosis for early and late intrahepatic recurrence after resection of hepatocellular carcinoma. Cancer. 89(3):500-507.
4. Wang, F., et al. (2022), CT-Based Radiomics for the Recurrence Prediction of Hepatocellular Carcinoma After Surgical Resection. J Hepatocell Carcinoma. 9:453-465.
5. Banerjee, S., et al. (2015), A computed tomography radiogenomic biomarker predicts microvascular invasion and clinical outcomes in hepatocellular carcinoma. Hepatology. 62(3):792-800.
6. Zhou, Y., et al. (2017), CT-based radiomics signature: a potential biomarker for preoperative prediction of early recurrence in hepatocellular carcinoma. Abdom Radiol (NY). 42(6):1695-1704.
7. Ning, P., et al. (2020), Application of CT radiomics in prediction of early recurrence in hepatocellular carcinoma. Abdom Radiol (NY). 45(1):64-72.
8. An, C., et al. (2015), Single Hepatocellular Carcinoma: Preoperative MR Imaging to Predict Early Recurrence after Curative Resection. Radiology. 276(2):433-443.