Multiparametric Magnetic Resonance Imaging Improves the Prognostic Outcomes in Patients With Intrahepatic Cholangiocarcinoma After Curative-Intent Resection
Abstract:PurposeThe prognosis of patients with intrahepatic cholangiocarcinoma remains unclear. Thus, this study aimed at investigating whether additional multiparametric magnetic resonance imaging (mpMRI) would guide additional treatment and improve the prognostic outcomes of intrahepatic cholangiocarcinoma patients.Methods and MaterialsThis retrospective study included 256 patients undergoing dynamic enhanced computed tomography scan only (CT group) and 31 patients undergoing both mpMRI and computed tomography scans … Show more
“…Tables 4 and 5 summarizes the characteristics of these studies. Including this study, a total of 21 articles probed OS [ 17 – 26 , 31 – 40 ] and 16 articles probed EFS [ 17 , 18 , 21 – 23 , 26 , 29 – 32 , 35 – 40 ] in patients with ICC. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Overexpression of HIF-1a in several cancers is relevant to angiogenesis, cell proliferation and survival, and accelerated tumor malignancy [ 52 ]. Studies not involved in the meta-analysis also confirmed the better prognosis of highly enhancing ICC [ 20 , 24 ]; nevertheless, there were also studies that did not include enhancement pattern as a prognostic factor, probably because the prognostic impact of imaging features was statistically underestimated in a small number of subjects, considering the relatively high prognostic power of pathological features [ 31 , 32 ]. Compared with unresectable cases, hyperenhancement pattern is more frequent in resectable ICCs, thus, enhancement patterns in HAP may be used for treatment decisions, including the feasibility of surgery and the choice of neoadjuvant therapy [ 23 ].…”
Background
To evaluate the prognostic role of imaging features based on CT and MRI in intrahepatic cholangiocarcinoma (ICC).
Methods
Two hundred and four patients from a single-center database who underwent radical ICC surgery from 2010 to 2019 were enrolled in the study. Cox proportional hazard model was used for survival analysis of imaging features. A meta-analysis was performed to determine imaging features that predict overall survival (OS) and event-free survival (EFS) in ICC.
Results
In the CT group of the retrospective cohort, tumor multiplicity, infiltrative tumor margin, lymph node metastasis, enhancement pattern in hepatic arterial phase and tumor necrosis correlated with poorer EFS and OS; moreover, enhancing capsules, high carcinoembryonic antigen levels contributed to poor OS. In the MRI group, tumor multiplicity and enhancement pattern were prognostic factors for OS; tumor multiplicity and enhancement pattern resulted in poor EFS. A total of 13 articles containing 1822 patients with ICC were enrolled in the adjusted hazard ratios meta-analysis. The results showed that enhancement pattern and infiltrative tumor margin were predictors of OS and EFS, whereas bile duct invasion was a predictor of OS.
Conclusions
Arterial enhancement patterns and tumor margin status were associated with both OS and EFS of ICC patients following resection.
“…Tables 4 and 5 summarizes the characteristics of these studies. Including this study, a total of 21 articles probed OS [ 17 – 26 , 31 – 40 ] and 16 articles probed EFS [ 17 , 18 , 21 – 23 , 26 , 29 – 32 , 35 – 40 ] in patients with ICC. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Overexpression of HIF-1a in several cancers is relevant to angiogenesis, cell proliferation and survival, and accelerated tumor malignancy [ 52 ]. Studies not involved in the meta-analysis also confirmed the better prognosis of highly enhancing ICC [ 20 , 24 ]; nevertheless, there were also studies that did not include enhancement pattern as a prognostic factor, probably because the prognostic impact of imaging features was statistically underestimated in a small number of subjects, considering the relatively high prognostic power of pathological features [ 31 , 32 ]. Compared with unresectable cases, hyperenhancement pattern is more frequent in resectable ICCs, thus, enhancement patterns in HAP may be used for treatment decisions, including the feasibility of surgery and the choice of neoadjuvant therapy [ 23 ].…”
Background
To evaluate the prognostic role of imaging features based on CT and MRI in intrahepatic cholangiocarcinoma (ICC).
Methods
Two hundred and four patients from a single-center database who underwent radical ICC surgery from 2010 to 2019 were enrolled in the study. Cox proportional hazard model was used for survival analysis of imaging features. A meta-analysis was performed to determine imaging features that predict overall survival (OS) and event-free survival (EFS) in ICC.
Results
In the CT group of the retrospective cohort, tumor multiplicity, infiltrative tumor margin, lymph node metastasis, enhancement pattern in hepatic arterial phase and tumor necrosis correlated with poorer EFS and OS; moreover, enhancing capsules, high carcinoembryonic antigen levels contributed to poor OS. In the MRI group, tumor multiplicity and enhancement pattern were prognostic factors for OS; tumor multiplicity and enhancement pattern resulted in poor EFS. A total of 13 articles containing 1822 patients with ICC were enrolled in the adjusted hazard ratios meta-analysis. The results showed that enhancement pattern and infiltrative tumor margin were predictors of OS and EFS, whereas bile duct invasion was a predictor of OS.
Conclusions
Arterial enhancement patterns and tumor margin status were associated with both OS and EFS of ICC patients following resection.
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