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Hepatology International
Published in: Hepatology International 2/2016

01-03-2016 | Original Article

The arterial tumor enhancement pattern on contrast-enhanced computed tomography is associated with primary cancer death after radiofrequency ablation for small hepatocellular carcinoma

Authors: Ryo Shimizu, Hideyuki Tamai, Yoshiyuki Mori, Naoki Shingaki, Shuya Maeshima, Junya Nuta, Yoshimasa Maeda, Kosaku Moribata, Yosuke Muraki, Hisanobu Deguchi, Izumi Inoue, Takao Maekita, Mikitaka Iguchi, Jun Kato, Masao Ichinose

Published in: Hepatology International | Issue 2/2016

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Abstract

Background/Purpose

Critical recurrences after radiofrequency ablation for hepatocellular carcinoma (HCC), such as intrahepatic metastases or dissemination, and extrahepatic metastases or seeding, which are difficult to treat radically, almost certainly lead to primary cancer death. The present study aimed to clarify whether the arterial tumor enhancement pattern on contrast-enhanced computed tomography (CECT) is associated with critical recurrence and cancer death after RFA for small HCC.

Methods

Between April 2001 and September 2011, 226 patients with initial small hypervascular HCC (≤3 cm in diameter and ≤3 tumors) were treated by RFA. Arterial tumor enhancement patterns on CECT before RFA were categorized by whether non-enhanced areas were included inside the tumor stain.

Results

The heterogeneous enhancement group included 44 patients, and the homogeneous enhancement group included 182 patients. The cumulative 5-year critical recurrence rates of the heterogeneous and homogeneous enhancement groups were 42 and 22 % (p = 0.005), respectively. Univariate analysis for factors related to critical recurrence showed significant differences in sex, arterial enhancement pattern, and response to antiviral therapy. These factors were independent on multivariate analysis. The cumulative 5-year primary cancer death rates of the heterogeneous and homogeneous enhancement groups were 29 and 13 % (p = 0.002), respectively. Univariate analysis for factors related to primary cancer death showed significant differences in arterial enhancement pattern and response to antiviral therapy. These factors were independent on multivariate analysis.

Conclusions

Arterial heterogeneous tumor enhancement on CECT is associated with critical recurrence and cancer death after RFA for small HCC.
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Metadata
Title
The arterial tumor enhancement pattern on contrast-enhanced computed tomography is associated with primary cancer death after radiofrequency ablation for small hepatocellular carcinoma
Authors
Ryo Shimizu
Hideyuki Tamai
Yoshiyuki Mori
Naoki Shingaki
Shuya Maeshima
Junya Nuta
Yoshimasa Maeda
Kosaku Moribata
Yosuke Muraki
Hisanobu Deguchi
Izumi Inoue
Takao Maekita
Mikitaka Iguchi
Jun Kato
Masao Ichinose
Publication date
01-03-2016
Publisher
Springer India
Published in
Hepatology International / Issue 2/2016
Print ISSN: 1936-0533
Electronic ISSN: 1936-0541
DOI
https://doi.org/10.1007/s12072-015-9678-1

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