Computed tomography predictors of hepatocellular carcinoma tumour necrosis after chemoembolization.

Academic Article


  • BACKGROUND: Radiographical features associated with a favourable response to trans-arterial chemoembolization (TACE) are poorly defined for patients with hepatocellular carcinoma (HCC). METHODS: From 2008 to 2012, all first TACE interventions for HCC performed at the University of Alabama at Birmingham (UAB) were retrospectively reviewed. Only patients with a pre-TACE and a post-TACE computed tomography (CT) scan were included in the analyses (n = 115). HCC tumour response to TACE was quantified via the the modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria. Univariate and multivariable analyses were constructed. RESULTS: The index HCC tumours experienced a > 90% or complete tumour necrosis in 59/115 (51%) of patients after the first TACE intervention. On univariate analysis, smaller tumour size, peripheral tumour location and arterial enhancement were associated with a > 90% or complete tumour necrosis, whereas, only smaller tumour size [odds ratio (OR) 0.62; 95% confidence interval (CI) 0.48, 0.81] and peripheral location (OR 6.91; 95% CI 1.75, 27.29) were significant on multivariable analysis. There was a trend towards improved survival in the patients that experienced a > 90% or complete tumour necrosis (P = 0.08). CONCLUSIONS: Peripherally located smaller HCC tumours are most likely to experience a > 90% or complete tumour necrosis after TACE. Surprisingly, arterial-phase enhancement and portal venous-phase washout were not significantly predictive of TACE-induced tumour necrosis. The TACE response was not statistically associated with improved survival.
  • Published In

  • HPB  Journal
  • Keywords

  • Alabama, Carcinoma, Hepatocellular, Chemoembolization, Therapeutic, Humans, Kaplan-Meier Estimate, Liver Neoplasms, Logistic Models, Male, Middle Aged, Multidetector Computed Tomography, Multivariate Analysis, Necrosis, Odds Ratio, Patient Selection, Predictive Value of Tests, Retrospective Studies, Treatment Outcome
  • Digital Object Identifier (doi)

    Author List

  • Bryant MK; Dorn DP; Zarzour J; Smith JK; Redden DT; Saddekni S; Abdel Aal AK; Gray SH; Eckhoff DE; Dubay DA
  • Start Page

  • 327
  • End Page

  • 335
  • Volume

  • 16
  • Issue

  • 4