Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Apr 15, 2024; 16(4): 1192-1203
Published online Apr 15, 2024. doi: 10.4251/wjgo.v16.i4.1192
Pre-operative enhanced magnetic resonance imaging combined with clinical features predict early recurrence of hepatocellular carcinoma after radical resection
Jian-Ping Chen, Ri-Hui Yang, Tian-Hui Zhang, Li-An Liao, Yu-Ting Guan, Hai-Yang Dai
Jian-Ping Chen, Department of Intervention, Meizhou People’s Hospital, Meizhou 514031, Guangdong Province, China
Ri-Hui Yang, Tian-Hui Zhang, Li-An Liao, Yu-Ting Guan, Department of Medical Imaging, Meizhou People’s Hospital, Meizhou 514031, Guangdong Province, China
Hai-Yang Dai, Department of Medical Imaging, Huizhou Municipal Central Hospital, Huizhou 516001, Guangdong Province, China
Co-first authors: Jian-Ping Chen and Ri-Hui Yang.
Author contributions: Chen JP and Yang RH contributed equally to this work; Chen JP wrote the first draft, and contributed to the writing of subsequent versions; Data was acquired and prepared for analysis by Yang RH and Liao LA; Statistical analyses and preparation of tables and figures was performed by Guan YT and Zhang TH; Dai HY was responsible for project administration and supervision; and all authors participated in the study design, interpretation of the data, and critically reviewing the paper.
Institutional review board statement: This study was reviewed and approved by the Meizhou People’s Hospital Institutional Review Board (Approval No. 2022-C-36).
Informed consent statement: The informed consent was waived from the patients and the presented data are anonymized.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at d.oocean@163.com.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hai-Yang Dai, MD, Chief Doctor, Deputy Director, Department of Medical Imaging, Huizhou Municipal Central Hospital, No. 41 North Eling Road, Huizhou 516001, Guangdong Province, China. d.ocean@163.com
Received: October 17, 2023
Peer-review started: October 17, 2023
First decision: January 15, 2024
Revised: January 28, 2024
Accepted: February 28, 2024
Article in press: February 28, 2024
Published online: April 15, 2024
Processing time: 176 Days and 13.8 Hours
Abstract
BACKGROUND

Indentifying predictive factors for postoperative recurrence of hepatocellular carcinoma (HCC) has great significance for patient prognosis.

AIM

To explore the value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced magnetic resonance imaging (MRI) combined with clinical features in predicting early recurrence of HCC after resection.

METHODS

A total of 161 patients with pathologically confirmed HCC were enrolled. The patients were divided into early recurrence and non-early recurrence group based on the follow-up results. The clinical, laboratory, pathological results and Gd-EOB-DTPA enhanced MRI imaging features were analyzed.

RESULTS

Of 161 patients, 73 had early recurrence and 88 were had non-early recurrence. Univariate analysis showed that patient age, gender, serum alpha-fetoprotein level, the Barcelona Clinic Liver Cancer stage, China liver cancer (CNLC) stage, microvascular invasion (MVI), pathological satellite focus, tumor size, tumor number, tumor boundary, tumor capsule, intratumoral necrosis, portal vein tumor thrombus, large vessel invasion, nonperipheral washout, peritumoral enhancement, hepatobiliary phase (HBP)/tumor signal intensity (SI)/peritumoral SI, HBP peritumoral low signal and peritumoral delay enhancement were significantly associated with early recurrence of HCC after operation. Multivariate logistic regression analysis showed that patient age, MVI, CNLC stage, tumor boundary and large vessel invasion were independent predictive factors. External data validation indicated that the area under the curve of the combined predictors was 0.861, suggesting that multivariate logistic regression was a reasonable predictive model for early recurrence of HCC.

CONCLUSION

Gd-EOB-DTPA enhanced MRI combined with clinical features would help predicting the early recurrence of HCC after operation.

Keywords: Hepatocellular carcinoma; Enhanced magnetic resonance imaging; Microvascular invasion; Hepatobiliary phase; Recurrence

Core Tip: Indentifying predictive factors for postoperative recurrence of hepatocellular carcinoma (HCC) has great significance for patient prognosis. In this retrospective cohort study, we analyzed the clinical, laboratory, pathological results and enhanced magnetic resonance imaging features of 161 HCC patients. Statistical analysis showed that patient age, microvascular invasion, the China live cancer stage, tumor boundary and large vessel invasion were independent predictive factors for predicting early recurrence of HCC. The results were further validated by external data and proved good predictive performance. This study may provide some assistance for the development of personalized treatment plans for HCC patients.