Radiologic Patterns Determine the Outcomes of Initial and Subsequent Transarterial Chemoembolization in Intermediate-Stage Hepatocellular Carcinoma.

IF 2.1 2区生物学 Q2 BEHAVIORAL SCIENCES Animal Behaviour Pub Date : 2023-05-15 eCollection Date: 2024-02-01 DOI:10.1159/000530950

Ya-Wen Hung, I-Cheng Lee, Chen-Ta Chi, Rheun-Chuan Lee, Chien-An Liu, Nai-Chi Chiu, Hsuen-En Hwang, Yee Chao, Ming-Chih Hou, Yi-Hsiang Huang

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Abstract

Introduction: Outcomes of transarterial chemoembolization (TACE) for intermediate-stage hepatocellular carcinoma (HCC) are diverse because of the heterogeneity of tumor burden. Radiologic pattern is one criterion for determining whether TACE is unsuitable. However, additional evidence is required. This study determined the influence of radiologic morphology on the outcomes of initial and subsequent TACE.

Methods: From January 2007 to September 2021, 633 treatment-naive patients with HCC with intermediate-stage HCC undergoing TACE were retrospectively enrolled. Of these patients, 386 patients received repeated TACE. The radiological features of HCC were evaluated by two radiologists and classified into encapsulated nodular type, simple nodular type with extranodular growth, confluent multinodular type, and infiltrative type. The objective response rate (ORR) and survival rate after initial and subsequent TACE among various radiologic morphologies were compared.

Results: After initial TACE, encapsulated nodular type HCC had the highest ORR (58%), followed by extranodular type (45.8%), confluent multinodular type (29%), and infiltrative type (19.5%). Notably, radiologic pattern was highly associated with tumor burden. Tumor burden and radiologic morphology were significantly associated with ORR and overall survival (OS) in the multivariate analysis. In 386 patients with subsequent TACE, encapsulated nodular type HCC had the highest ORR (48.7%), followed by extranodular type (37.3%), confluent multinodular type (26.2%), and infiltrative type (10%). In the multivariate analysis, radiologic features were significant independent predictors of ORR and OS after receiving subsequent TACE.

Conclusion: Radiologic patterns determine the outcomes of initial and subsequent TACE. Systemic therapy should be considered for patients with intermediate-stage HCC with unfavorable radiologic patterns.

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放射学模式决定中晚期肝细胞癌首次和后续经动脉化疗栓塞术的疗效

简介：由于肿瘤负荷的异质性，经动脉化疗栓塞术（TACE）治疗中期肝细胞癌（HCC）的结果多种多样。放射学模式是确定 TACE 是否不适合的标准之一。但是，还需要更多的证据。本研究确定了放射学形态对初次和后续 TACE 结果的影响：2007年1月至2021年9月期间，回顾性纳入了633名接受TACE的中晚期HCC患者。其中，386 名患者接受了重复 TACE。两名放射科医生对HCC的放射学特征进行了评估，并将其分为包裹结节型、伴有结节外生长的单纯结节型、汇合多结节型和浸润型。比较了不同放射学形态初次TACE和后续TACE后的客观反应率（ORR）和生存率：结果：初次TACE后，包裹结节型HCC的ORR最高（58%），其次是结节外型（45.8%）、汇合多结节型（29%）和浸润型（19.5%）。值得注意的是，放射学形态与肿瘤负荷高度相关。在多变量分析中，肿瘤负荷和放射学形态与ORR和总生存率（OS）显著相关。在386名接受TACE治疗的患者中，包裹结节型HCC的ORR最高（48.7%），其次是结节外型（37.3%）、汇合多结节型（26.2%）和浸润型（10%）。在多变量分析中，放射学特征是后续TACE治疗后ORR和OS的重要独立预测因素：结论：放射学模式决定了初次和后续 TACE 的疗效。结论：放射学模式决定了初次和后续 TACE 的疗效，对于放射学模式不佳的中晚期 HCC 患者，应考虑进行系统治疗。

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来源期刊

Animal Behaviour 生物-动物学

CiteScore

4.60

自引率

8.00%

发文量

236

审稿时长

10.2 weeks

期刊介绍： Growing interest in behavioural biology and the international reputation of Animal Behaviour prompted an expansion to monthly publication in 1989. Animal Behaviour continues to be the journal of choice for biologists, ethologists, psychologists, physiologists, and veterinarians with an interest in the subject.