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Preoperative estimation of the survival of patients with unresectable hepatocellular carcinoma achieving complete response after conventional transcatheter arterial chemoembolization: assessments of clinical and LI-RADS MR features

  • Abdominal Radiology
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Abstract

Purpose

To identify the associations of clinical and magnetic resonance (MR) features with overall survival (OS) in patients with unresectable hepatocellular carcinoma (HCC) achieving complete response (CR) after conventional transcatheter arterial chemoembolization (TACE) and to further develop an individual nomograph to estimate the survival probability.

Materials and methods

A total of 112 patients with unresectable HCC treated with TACE as first-line treatment were retrospectively evaluated. Potential risk factors associated with OS were identified by univariate and multivariate Cox analyses. The survival model was developed by multivariate Cox proportional hazard model. The area under the receiver operating characteristic curve was calculated to assess the performance of each marker and of the whole model. Discrimination was performed using Kaplan–Meier curves, and the survival curves were compared by the log-rank test. A nomogram derived from the survival model was established.

Results

Multivariate Cox analyses indicated that nonsmooth tumor margin, peritumoral enhancement, fat sparing in solid mass, and Barcelona clinic liver cancer (BCLC) stage were independent risk indicators associated with OS. The survival model showed acceptable diagnostic power, with an area under the curve (AUC) of 0.687. Kaplan–Meier curves demonstrated that the model discriminated well, as the high-risk and low-risk groups had median survival times of 21.6 months and 34.8 months, respectively (log-rank test, P = 0.01).

Conclusions

Nonsmooth tumor margin, peritumoral enhancement, fat sparing in solid mass, and BCLC stage were potential biomarkers to evaluate the survival with favorable performance and discriminate HCC patients with CR under conventional TACE treatment.

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Acknowledgements

The authors are grateful to American Journal Experts (AJE) for their assistance with language editing.

Funding

This work was supported by the Medical Scientific Research Joint Project of Chongqing Health Commission and Science and Technology Bureau in China (Grant: 2022MSXM071, 2022MSXM022).

Author information

Author notes

  1. The authors Wenlong Song and Qianyu Chen contributed equally to the work.

Authors and Affiliations

  1. Department of Radiology, The Ninth People Hospital of Chongqing, No.69 Jialing Village, Beibei District, Chongqing, 400010, China

    Wenlong Song & Caiming Jiang

  2. Department of Ultrasonography, The Ninth People Hospital of Chongqing, Chongqing, China

    Qianyu Chen

  3. Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

    Wenlong Song & Dajing Guo

Authors
  1. Wenlong Song
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Contributions

DJG and CMJ proposed the study. WLS, QYC and DJG collected the data, analyzed the data and wrote the first draft. CMJ final approval. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Caiming Jiang.

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The study protocol was approved by Institutional Review Board of our institution, the informed consent was not required.

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Song, W., Chen, Q., Guo, D. et al. Preoperative estimation of the survival of patients with unresectable hepatocellular carcinoma achieving complete response after conventional transcatheter arterial chemoembolization: assessments of clinical and LI-RADS MR features. Radiol med 127, 939–949 (2022). https://doi.org/10.1007/s11547-022-01517-1

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