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03.04.2020 | Hepatobiliary Tumors

Surgical Indications for Hepatocellular Carcinoma with Non-hypervascular Hypointense Nodules Detected by Gd-EOB-DTPA-Enhanced MRI

verfasst von: Kazuki Takeishi, MD, PhD, Tomoharu Yoshizumi, MD, PhD, Shinji Itoh, MD, PhD, Kyohei Yugawa, MD, Shohei Yoshiya, MD, PhD, Takeo Toshima, MD, PhD, Noboru Harada, MD, PhD, Toru Ikegami, MD, PhD, Akihiro Nishie, MD, PhD, Masaki Mori, MD, PhD

Erschienen in: Annals of Surgical Oncology | Ausgabe 9/2020

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Abstract

Background

The surgical indication for non-hypervascular hypointense nodules (NHVN) detected incidentally on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (Gd-EOB-MRI) for classical hepatocellular carcinoma (HCC) is unknown. Our aim is to clarify the long-term outcomes in patients with this finding.

Methods

We reviewed the cases of 290 HCC patients, including 66 patients with NHVN, who underwent Gd-EOB-MRI prior to hepatectomy, between October 2008 and December 2017 at our center. We divided the patients into three groups: a no-NHVN group, a treated NHVN group, and an untreated NHVN group.

Results

There was no significant difference in (RFS) or overall survival (OS) between the no-NHVN and untreated NHVN groups (p = 0.103 and 0.103, respectively). There was no significant difference between these two groups after propensity score matching. Multivariate analyses showed that microscopic intrahepatic metastases and the size of the main classical HCC, the target tumor, were independent prognostic factors of overall survival, but the presence of non-hypervascular hypointense nodules was not. There was no significant difference in RFS or OS between the treated NHVN and untreated NHVN groups (p = 0.158 and 0.109, respectively).

Conclusions

Non-hypervascular hypointense nodules detected incidentally on Gd-EOB-MRI associated with targeted hypervascular HCC did not reflect prognosis of HCC after hepatectomy. Surgical procedures for classical enhancing HCC may be performed even if non-hypervascular hypointense nodules adjacent to the targeted HCC cannot be removed completely.
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Metadaten
Titel
Surgical Indications for Hepatocellular Carcinoma with Non-hypervascular Hypointense Nodules Detected by Gd-EOB-DTPA-Enhanced MRI
verfasst von
Kazuki Takeishi, MD, PhD
Tomoharu Yoshizumi, MD, PhD
Shinji Itoh, MD, PhD
Kyohei Yugawa, MD
Shohei Yoshiya, MD, PhD
Takeo Toshima, MD, PhD
Noboru Harada, MD, PhD
Toru Ikegami, MD, PhD
Akihiro Nishie, MD, PhD
Masaki Mori, MD, PhD
Publikationsdatum
03.04.2020
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 9/2020
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-020-08419-4

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