- Follow-up of Hepatocellular Carcinoma After Transarterial Chemoembolization; The Concordance of Contrast Enhanced Ultrasonography and Lipiodol CT
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Gene Hyun Bok, Soung Won Jeong, Jae Young Jang, Sae Hwan Lee, Sang Gyune Kim, Sang-Woo Cha, Young Seok Kim, Young Deok Cho, Hong Soo Kim, Boo Sung Kim
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J Liver Cancer. 2014;14(2):115-119. Published online September 30, 2014
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DOI: https://doi.org/10.17998/jlc.14.2.115
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Abstract
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- Background/Aim
s: The aim of this study is to evaluate the concordance of contrast-enhanced
ultrasonography (CEUS) and lipiodol computed tomography (L-CT) for the assessment of
viable hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE). Methods We retrospectively reviewed the post-TACE CEUS and L-CT images of 65
consecutive HCCs in 41 patients to assess the presence of viable tumor tissue. Forty-seven
HCCs in 31 patients that underwent post-TACE L-CT within 4 weeks of the CEUS examination
were included. The degree of concordance between CEUS and L-CT and factors related to
concordance were analyzed. Results The overall concordance of CEUS and LDCT was 78.7% (37/47). The concordance with
L-CT for viable tumor and non-viable tumor tissue on CEUS was 95.2%, and 65.4% respectively
(P<0.013). Diffuse tumors had a tendency for non-concordance (P=0.066). Although 3 of 4
lesions located in the hepatic dome were non-concordant, the sample size was too small to
establish significance. The mean tumor size for concordant and non-concordant tumors was
2.9 and 3.0 cm, with no significant difference. Conclusions Although the concordance of CEUS and L-CT for viable tumor tissue was
high, the concordance for non-viable tumor tissue was relatively low. Prospective studies
using angiography as a gold standard should be performed in the future. (J Liver Cancer
2014;14:115-119)
- The Comparison of Overall Survival between Child C with Early Stage HCC and Child A with Advanced Stage HCC
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Eui Ju Park, Jae Young Jang, Soung Won Jeong, Jin Woo Choo, Jin Nyoung Kim, Soon Ha Kwon, Byoung Moo Lee, Sae Hwan Lee, Sang Gyune Kim, Sang-Woo Cha, Young Seok Kim, Young Deok Cho, Hong Soo Kim, Boo Sung Kim
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Journal of the Korean Liver Cancer Study Group. 2013;13(2):136-144. Published online September 30, 2013
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DOI: https://doi.org/10.17998/jlc.13.2.136
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Abstract
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- Background/Aim
s: The prognosis of hepatocellular carcinoma (HCC) is affected by stage as well as liver function. We analyzed the survival outcome of early stage HCC in Child class C patients and advanced HCC in Child class A patients.
Methods Among 453 HCC patients with good performance status, Group A included 33 consecutive Child class C patients with early stage (I, II) HCC, and Group B included 45 consecutive Child class A patients with advanced stage (III, IV) HCC. We investigated the clinical characteristics, cirrhotic complications, and prognostic factors related with survival in each group, and compared overall survival between two groups.
Results Age, prothrombin time, total bilirubin and Model for End-Stage Liver Disease (MELD) scores were significantly higher in Group A. Male sex, platelet count, albumin, sodium (Na), hepatitis B virus, alpha fetoprotein (AFP) and portal vein thrombosis were significantly higher in Group B. Complications of cirrhosis such as variceal bleeding, ascites, and hepatic encephalopathy were increased in Group A (P<0.05). Patients with an elevated AFP (>400 ng/mL) tended to exhibit poor survival as it increased in Group A (P=0.084). MELD scores>15 (Hazard ratio[HR] 17.84, 95% confidence interval [CI] 3.70-85.93, P<0.001), stage IV (HR:3.27, 95% CI 1.10-9.75, P=0.033), and absence of HCC treatment (HR: 3.70, 95% CI 1.06-12.50, P=0.040) were independent poor prognostic factors in Group B. Median overall survival was 24.6 months (95% CI 10.6-38.4) for Group A and 13.5 months (95% CI 4.6-22.3) for Group B (P=0.278). In the HCC treatment group, there were no significant differences of median overall survival between Group A and Group B, respectively (27.1 vs. 15.7 months, P=0.338). In patients with conservative treatment, Group A and Group B had a significantly different median overall survival of 13.6 and 2.5 months, respectively (P=0.012). In patients of Group B, median overall survival was significantly higher in patients who received treatment of HCC compared to those who did not, respectively (15.7 vs. 2.5 months, P<0.001).
Conclusions Overall median survival was not different between both groups. However, in Child class A patients with advanced stage HCCs, the cumulative median survival was higher in patients who received treatment of HCC compared to those who did not. Therefore, advanced stage HCC patients with good liver function should be considered for HCC treatments.
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