nach oben

Erschienen in:

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

verfasst von: 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

Erschienen in: Hepatology International | Ausgabe 2/2016

Einloggen, um Zugang zu erhalten

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.

Arii S, Teramoto K, Kawamura T, Okamoto H, Kaido T, Mori A, Imamura M. Characteristics of recurrent hepatocellular carcinoma in Japan and our surgical experience. J Hepatobiliary Pancreat Surg. 2001;8:397–403CrossRefPubMed

Clinical Practice Guidelines for Hepatocellular Carcinoma. The Japan Society of Hepatology 2009 update. Hepatol Res. 2010;40(Suppl 1):2–144

EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol 2012;56:908–943

Takada Y, Kurata M, Ohkohchi N. Rapid and aggressive recurrence accompanied by portal tumor thrombus after radiofrequency ablation for hepatocellular carcinoma. Int J Clin Oncol. 2003;8:332–335CrossRefPubMed

Ruzzenente A, Manzoni GD, Molfetta M, Pachera S, Genco B, Donataccio M, Guglielmi A. Rapid progression of hepatocellular carcinoma after radiofrequency ablation. World J Gastroenterol. 2004;10:1137–1140PubMedPubMedCentral

Nicoli N, Casaril A, Abu Hilal M, Mangiante G, Marchiori L, Ciola M, Invernizzi L, Campagnaro T, Mansueto G. A case of rapid intrahepatic dissemination of hepatocellular carcinoma after radiofrequency thermal ablation. Am J Surg. 2004;188:165–167CrossRefPubMed

Masuda T, Beppu T, Ishiko T, Horino K, Baba Y, Mizumoto T, Hayashi H, Okabe H, Horlad H, Doi K, Okabe K, Takamori H, Hirota M, Iyama K, Baba H. Intrahepatic dissemination of hepatocellular carcinoma after local ablation therapy. J Hepatobiliary Pancreat Surg. 2008;15:589–595CrossRefPubMed

Mori Y, Tamai H, Shingaki N, Moribata K, Shiraki T, Deguchi H, Ueda K, Enomoto S, Magari H, Inoue I, Maekita T, Iguchi M, Yanaoka K, Oka M, Ichinose M. Diffuse intrahepatic recurrence after percutaneous radiofrequency ablation for solitary and small hepatocellular carcinoma. Hepatol Int. 2009;3:509–515CrossRefPubMedPubMedCentral

Imamura J, Tateishi R, Shiina S, Goto E, Sato T, Ohki T, Masuzaki R, Goto T, Yoshida H, Kanai F, Hamamura K, Obi S, Yoshida H, Omata M. Neoplastic seeding after radiofrequency ablation for hepatocellular carcinoma. Am J Gastroenterol. 2008;103:3057–3062CrossRefPubMed

10.

Shirai K, Tamai H, Shingaki N, Mori Y, Moribata K, Enomoto S, Deguchi H, Ueda K, Maekita T, Inoue I, Iguchi M, Yanaoka K, Oka M, Ichinose M. Clinical features and risk factors of extrahepatic seeding after percutaneous radiofrequency ablation for hepatocellular carcinoma. Hepatol Res. 2011;41:738–745CrossRefPubMed

11.

Yang Y, Nagano H, Ota H, Morimoto O, Nakamura M, Wada H, Noda T, Damdinsuren B, Marubashi S, Miyamoto A, Takeda Y, Dono K, Umeshita K, Nakamori S, Wakasa K, Sakon M, Monden M. Patterns and clinicopathologic features of extrahepatic recurrence of hepatocellular carcinoma after curative resection. Surgery. 2007;141:196–202CrossRefPubMed

12.

Kawano Y, Sasaki A, Kai S, Endo Y, Iwaki K, Uchida H, Shibata K, Ohta M, Kitano S. Prognosis of patients with intrahepatic recurrence after hepatic resection for hepatocellular carcinoma: a retrospective study. Eur J Surg Oncol. 2009;35:174–179CrossRefPubMed

13.

Esnaola NF, Lauwers GY, Mirza NQ, Nagorney DM, Doherty D, Ikai I, Yamaoka Y, Regimbeau JM, Belghiti J, Curley SA, Ellis LM, Vauthey JN. Predictors of microvascular invasion in patients with hepatocellular carcinoma who are candidates for orthotopic liver transplantation. J Gastrointest Surg. 2006;6:224–232 (discussion 232) CrossRef

14.

Silva MA, Hegab B, Hyde C, Guo B, Buckels JA, Mirza DF. Needle track seeding following biopsy of liver lesions in the diagnosis of hepatocellular cancer: a systematic review and meta-analysis. Gut. 2008;57:1592–1596CrossRefPubMed

15.

Asayama Y, Yoshimitsu K, Nishihara Y, Irie H, Aishima S, Taketomi A, Honda H. Arterial blood supply of hepatocellular carcinoma and histologic grading: radiologic-pathologic correlation. Am J Roentgenol. 2008;190:W28–W34CrossRef

16.

Nakachi K, Tamai H, Mori Y, Shingaki N, Moribata K, Deguchi H, Ueda K, Inoue I, Maekita T, Iguchi M, Kato J, Ichinose M. Prediction of poorly differentiated hepatocellular carcinoma using contrast computed tomography. Cancer Imaging. 2014;14:17PubMedPubMedCentral

17.

Bedossa P, Poynard T. An algorithm for the grading of activity in chronic hepatitis C. The METAVIR Cooperative Study Group. Hepatology. 1996;24:289–293CrossRefPubMed

18.

Sanada Y, Yoshida K, Itoh H. Comparison of CT enhancement patterns and histologic features in hepatocellular carcinoma up to 2 cm: assessment of malignant potential with claudin-10 immunohistochemistry. Oncol Rep. 2007;17:1177–1182PubMed

19.

Kawamura Y, Ikeda K, Hirakawa M, Yatsuji H, Sezaki H, Hosaka T, Akuta N, Kobayashi M, Saitoh S, Suzuki F, Suzuki Y, Arase Y, Kumada H. New classification of dynamic computed tomography images predictive of malignant characteristics of hepatocellular carcinoma. Hepatol Res. 2010;40:1006–1014CrossRefPubMed

20.

Kawamura Y, Ikeda K, Seko Y, Hosaka T, Kobayashi M, Saitoh S, Kumada H. Heterogeneous type 4 enhancement of hepatocellular carcinoma on dynamic CT is associated with tumor recurrence after radiofrequency ablation. Am J Roentgenol. 2011;197:W665–W673CrossRef

21.

Nishie A, Yoshimitsu K, Okamoto D, Tajima T, Asayama Y, Ishigami K, Kakihara D, Nakayama T, Takayama Y, Shirabe K, Fujita N, Honda H. CT prediction of histological grade of hypervascular hepatocellular carcinoma: utility of the portal phase. Jpn J Radiol. 2013;31:89–98CrossRefPubMed

22.

Shiina S, Tateishi R, Arano T, Uchino K, Enooku K, Nakagawa H, Asaoka Y, Sato T, Masuzaki R, Kondo Y, Goto T, Yoshida H, Omata M, Koike K. Radiofrequency ablation for hepatocellular carcinoma: 10-year outcome and prognostic factors. Am J Gastroenterol. 2012;107:569–577 (quiz 578) CrossRefPubMedPubMedCentral

23.

Okuda H, Nakanishi T, Takatsu K, Saito A, Hayashi N, Takasaki K, Takenami K, Yamamoto M, Nakano M. Serum levels of des-gamma-carboxy prothrombin measured using the revised enzyme immunoassay kit with increased sensitivity in relation to clinicopathologic features of solitary hepatocellular carcinoma. Cancer. 2000;88:544–549CrossRefPubMed

24.

Sun P, Yang X, He RQ, Hu QG, Song ZF, Xiong J, Zheng QC. Antiviral therapy after curative treatment of hepatitis B/C virus-related hepatocellular carcinoma: a systematic review of randomized trials. Hepatol Res. 2014;44:259–269CrossRefPubMed

25.

Sun P, Dong X, Cheng X, Hu Q, Zheng Q. Nucleot(s)ide analogues for hepatitis B virus-related hepatocellular carcinoma after curative treatment: a systematic review and meta-analysis. PLoS ONE. 2014;9:e102761CrossRefPubMedPubMedCentral

26.

Mazzaferro V, Romito R, Schiavo M, Mariani L, Camerini T, Bhoori S, Capussotti L, Calise F, Pellicci R, Belli G, Tagger A, Colombo M, Bonino F, Majno P, Llovet JM. Force HCCIT. Prevention of hepatocellular carcinoma recurrence with alpha-interferon after liver resection in HCV cirrhosis. Hepatology. 2006;44:1543–1554CrossRefPubMed

27.

Farinati F, Sergio A, Giacomin A, Di Nolfo MA, Del Poggio P, Benvegnu L, Rapaccini G, Zoli M, Borzio F, Giannini EG, Caturelli E, Trevisani F. Italian Liver Cancer g. Is female sex a significant favorable prognostic factor in hepatocellular carcinoma? Eur J Gastroenterol Hepatol. 2009;21:1212–1218CrossRefPubMed

28.

Ahmed M, Solbiati L, Brace CL, Breen DJ, Callstrom MR, Charboneau JW, Chen MH, Choi BI, de Baere T, Dodd GD 3rd, Dupuy DE, Gervais DA, Gianfelice D, Gillams AR, Lee FT Jr, Leen E, Lencioni R, Littrup PJ, Livraghi T, Lu DS, McGahan JP, Meloni MF, Nikolic B, Pereira PL, Liang P, Rhim H, Rose SC, Salem R, Sofocleous CT, Solomon SB, Soulen MC, Tanaka M, Vogl TJ, Wood BJ, Goldberg SN. International Working Group on image-guided tumor ablation, Interventional Oncology Sans Frontieres Expert Panel, Technology Assessment Committee of the Society of Interventional Radiology, Standard of Practice Committee of the Cardiovascular and Interventional Radiological Society of Europe. Image-guided tumor ablation: standardization of terminology and reporting criteria—a 10-year update. Radiology. 2014;273:241–260CrossRefPubMedPubMedCentral

Titel: The arterial tumor enhancement pattern on contrast-enhanced computed tomography is associated with primary cancer death after radiofrequency ablation for small hepatocellular carcinoma
verfasst von: 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
Publikationsdatum: 01.03.2016
Verlag: Springer India
Erschienen in: Hepatology International / Ausgabe 2/2016
Print ISSN: 1936-0533
Elektronische ISSN: 1936-0541
DOI: https://doi.org/10.1007/s12072-015-9678-1

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Background/Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2016

Low expression of N-myc downstream-regulated gene 2 (NDRG2) correlates with poor prognosis in hepatoblastoma

Percutaneous recanalization for hepatic vein-type Budd-Chiari syndrome: long-term patency and survival

Daclatasvir-containing all-oral regimens for the treatment of hepatitis C virus infection

Tenofovir rescue therapy in chronic hepatitis B patients who failed previous nucleoside analogue treatment

Effects of long-term entecavir treatment on the incidence of hepatocellular carcinoma in chronic hepatitis B patients

Evaluating the living donor: expansion by innovation