Aim:Survival in patients with hepatocellular carcinoma(HCC)is impacted by stage of liver disease,tumor characteristics,and HCC surveillance in high-risk individuals.Factors associated with HCC tumor growth rate(TGR)an...Aim:Survival in patients with hepatocellular carcinoma(HCC)is impacted by stage of liver disease,tumor characteristics,and HCC surveillance in high-risk individuals.Factors associated with HCC tumor growth rate(TGR)and its influence on recurrence-free survival after treatment was investigated.Methods:TGR was calculated in 164 HCC patients with chronic viral hepatitis who had two consecutive magnetic resonance imaging or computed tomography scans≥30 days apart prior to treatment and who were followed prospectively to determine the rates of recurrence-free survival.Results:The median TGR in 164 patients was 17.8%per month(mean 33.3%per month).Regression tree analysis indicated that the top three predictors of TGR were alpha-fetoprotein(AFP)levels(≥16.7 ng/mL),platelet counts(≥140,000 mm3),and serum albumin level(<3.55 g/dL).The regression tree identified patient groups with TGRs ranging from 0.65%to 39.4%per month.At a median follow-up of 22 months,the overall recurrence-free survival was 53.8%.The Cox model with backwards AIC search identified TGR(HR=1.34,P=0.029),age>56 years(HR=1.08,P=0.072),hepatitis C virus(HR=1.44,P=0.091),macrovascular invasion(HR=1.94,P=0.092),and the most definitive treatments(orthotopic liver transplantation,HR 0.14,P<0.001;surgical resection,HR=0.54,P=0.072;radiofrequency ablation,HR=0.58,P=0.060)as independent predictors of recurrence-free survival.For all treatment modalities,slow ;TGR was significant for prolonged survival(P=0.029).The poorest survival rates were observed in patients with fast TGRs treated by transarterial chemoembolization.Conclusion:The TGR correlated with AFP,platelet count,and albumin level.Patients with fast TGRs had shorter recurrence-free survival after HCC treatments.TGR is a potential imaging biomarker to predict clinical outcomes in HCC.展开更多
文摘Aim:Survival in patients with hepatocellular carcinoma(HCC)is impacted by stage of liver disease,tumor characteristics,and HCC surveillance in high-risk individuals.Factors associated with HCC tumor growth rate(TGR)and its influence on recurrence-free survival after treatment was investigated.Methods:TGR was calculated in 164 HCC patients with chronic viral hepatitis who had two consecutive magnetic resonance imaging or computed tomography scans≥30 days apart prior to treatment and who were followed prospectively to determine the rates of recurrence-free survival.Results:The median TGR in 164 patients was 17.8%per month(mean 33.3%per month).Regression tree analysis indicated that the top three predictors of TGR were alpha-fetoprotein(AFP)levels(≥16.7 ng/mL),platelet counts(≥140,000 mm3),and serum albumin level(<3.55 g/dL).The regression tree identified patient groups with TGRs ranging from 0.65%to 39.4%per month.At a median follow-up of 22 months,the overall recurrence-free survival was 53.8%.The Cox model with backwards AIC search identified TGR(HR=1.34,P=0.029),age>56 years(HR=1.08,P=0.072),hepatitis C virus(HR=1.44,P=0.091),macrovascular invasion(HR=1.94,P=0.092),and the most definitive treatments(orthotopic liver transplantation,HR 0.14,P<0.001;surgical resection,HR=0.54,P=0.072;radiofrequency ablation,HR=0.58,P=0.060)as independent predictors of recurrence-free survival.For all treatment modalities,slow ;TGR was significant for prolonged survival(P=0.029).The poorest survival rates were observed in patients with fast TGRs treated by transarterial chemoembolization.Conclusion:The TGR correlated with AFP,platelet count,and albumin level.Patients with fast TGRs had shorter recurrence-free survival after HCC treatments.TGR is a potential imaging biomarker to predict clinical outcomes in HCC.
