Computed tomography predictors of hepatocellular carcinoma tumour necrosis after chemoembolization. Issue 4 (26th August 2013)

• Record Type: Journal Article
• Authors: Bryant, Mary K.; Dorn, David P.; Zarzour, Jessica; Smith, J. Kevin; Redden, David T.; Saddekni, Souheil; Aal, Ahmed Kamel Abdel; Gray, Stephen H.; Eckhoff, Devin E.; DuBay, Derek A.
• Is Part Of: HPB. Volume 16:Issue 4(2014:Apr.)
• Page Start: 327
• Page End: 335
• Publication Date: 2013-08-26
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1111/hpb.12149
• Languages: English
• ISSNs: 1365-182X

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="hpb12149-sec-0001" sec-type="section"> <title>Background</title> <p>Radiographical features associated with a favourable response to trans‐arterial chemoembolization (TACE) are poorly defined for patients with hepatocellular carcinoma (HCC).</p> </sec> <sec id="hpb12149-sec-0002" sec-type="section"> <title>Methods</title> <p>From 2008 to 2012, all first TACE interventions for HCC performed at the University of Alabama at Birmingham (UAB) were retrospectively reviewed. Only patients with a pre‐TACE and a post‐TACE computed tomography (CT) scan were included in the analyses (<italic>n</italic> = 115). HCC tumour response to TACE was quantified via the the modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria. Univariate and multivariable analyses were constructed.</p> </sec> <sec id="hpb12149-sec-0003" sec-type="section"> <title>Results</title> <p>The index HCC tumours experienced a > 90% or complete tumour necrosis in 59/115 (51%) of patients after the first TACE intervention. On univariate analysis, smaller tumour size, peripheral tumour location and arterial enhancement were associated with a > 90% or complete tumour necrosis, whereas, only smaller tumour size [odds ratio (OR) 0.62; 95% confidence interval (CI) 0.48, 0.81] and peripheral location (OR 6.91; 95% CI 1.75, 27.29) were significant on multivariable analysis. There was a trend towards improved survival in the patients that experienced a > 90% or complete tumour necrosis (<italic>P</italic> = 0.08).</p> </sec> <sec id="hpb12149-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Peripherally located smaller HCC tumours are most likely to experience a > 90% or complete tumour necrosis after TACE. Surprisingly, arterial‐phase enhancement and portal venous‐phase washout were not significantly predictive of TACE‐induced tumour necrosis. The TACE response was not statistically associated with improved survival.</p> </sec> </abstract>