Tumor vascularity and lipiodol deposition as early radiological markers for predicting risk of disease progression in patients with unresectable hepatocellular carcinoma after transarterial chemoembolization
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Cheng-Shi Chen1, Fang-Kun Li1, Chen-Yang Guo1, Jin-Cheng Xiao1, Hong-Tao Hu1, Hong-Tao Cheng1, Lin Zheng1, Deng-Wei Zong1, Jun-Li Ma1, Li Jiang1, Hai-Liang Li1
1Department of Radiology, Zhengzhou University Affiliated Cancer Hospital, Zhengzhou 450008, China
Hai-Liang Li, e-mail: [email protected]
Keywords: hepatocellular carcinoma, transarterial chemoembolization, lipiodol, tumor vascularity, overall survival
Received: July 23, 2015 Accepted: December 04, 2015 Published: January 12, 2016
This study evaluated the factors impacting overall survival (OS) and time to progression (TTP) in patients with unresectable hepatocellular carcinoma (HCC) who received transarterial chemoembolization (TACE). HCC patients were grouped based on tumor vascularity and lipidiol deposition after TACE. Tumor vascularity was classified based on contrast enhancement on arterial phase baseline CT scans. Lipiodol deposition was evaluated using CT scans. The progression-free rate was significantly higher in patients with good blood supply + good lipiodol deposition compared to those with good blood supply + poor lipiodol deposition. In patients with poor lipidiol deposition, risk of death was significantly positively correlated with stage, and negatively correlated with number of TACE procedures and degree of lipidiol deposition after the first TACE. Risk of disease progression in these patients was positively correlated with tumor size, and negatively correlated with number of TACE procedures and degree of lipidiol deposition after the first TACE. Our data showed that tumor vascularity and lipiodol deposition can be used as early radiological markers to identify patients who do not respond to TACE, and who can be considered earlier for alternative combination treatment strategies. Our data also indicated that poor lipiodol retention may predict a poor TTP and OS despite the blood supply status.
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