Advanced Hepatocellular Carcinoma. Issue 5 (September 2015) - Lee, Sang Ho
Abstract Objective The aim of this study was to find prognostic biomarkers in perfusion computed tomography (PCT)–based kinetic parameters for advanced hepatocellular carcinoma (HCC) treated with antiangiogenic chemotherapy. Methods Twenty-two patients with advanced HCC underwent PCT imaging and subsequently received bevacizumab in combination with gemcitabine and oxaliplatin. Pretreatment PCT data within advanced HCC were analyzed using the Tofts-Kety, 2-compartment exchange, adiabatic approximation to the tissue homogeneity (AATH), and distributed parameter models. Blood flow, blood volume, extraction fraction (E), and other 3 parameters were calculated. Kinetic parameters in each model were evaluated with 1-year survival discrimination using Kaplan-Meier analysis and with overall survival using univariate Cox regression analysis. Results Only the AATH model–derived E was statistically significantly prognostic for 1-year survival. The increased AATH model–derived E was significantly associated with longer overall survival (P = 0.005). Conclusions The AATH model–derived E was an effective prognostic biomarker for advanced HCC.