GIÁ TRỊ CỦA CỘNG HƯỞNG TỪ TRƯỚC PHẪU THUẬT DỰ ĐOÁN TÁI PHÁT TRONG GAN SỚM SAU CẮT GAN THEO GIẢI PHẪU ĐIỀU TRỊ UNG THƯ BIỂU MÔ TẾ BÀO GAN

Abstract

Background: Hepatocellular carcinoma (HCC) is the leading cancer in terms of incidence and cancer-related mortality in Vietnam. Hepatic resection is the curative and standard treatment option for resectable HCC. However, the recurrence rate after liver resection remains high. Most recurrences occur early, within the first two years post-surgery, and are associated with a poor prognosis. Therefore, predicting early recurrence before making treatment decisions is necessary and crucial, as it may alter treatment strategies and postoperative follow-up timing. Objective: To determine the value of preoperative magnetic resonance imaging (MRI) in predicting early intrahepatic recurrence after anatomical liver resection for the treatment of hepatocellular carcinoma (HCC). Methods: This is a retrospective cohort study involving all HCC patients who underwent anatomical liver resection at the University Medical Center Ho Chi Minh City between January 1, 2018, and June 30, 2022, and who had undergone liver MRI within one month prior to surgery. Patients were followed until intrahepatic HCC recurrence or until October 30, 2024. Preoperative MRI features associated with early intrahepatic recurrence were analyzed. Kaplan-Meier analysis and Cox regression were used to evaluate the correlation between MRI features and early intrahepatic recurrence. Results: The rate of early intrahepatic recurrence was 34.5% (19/55). Seven MRI features were associated with early recurrence: (1) tumor morphology, (2) tumor size > 5 cm, (3) intratumoral artery, (4) portal vein invasion, (5) LI-RADS M category, (6) peritumoral enhancement, and (7) bile duct invasion. Among these, intratumoral artery, LI-RADS M category, and bile duct invasion were identified as independent predictors of early recurrence, with hazard ratios (HR) of 14.3, 10.7, and 8.9, respectively. Conclusion: Preoperative MRI has predictive value for assessing the risk of early intrahepatic recurrence after liver resection.