Non-hypervascular hypointense nodules detected by Gd-EOB-DTPA-enhanced MRI are a risk factor for recurrence of HCC after hepatectomy

Toyoda, Hidenori; Kumada, Takashi; Tada, Toshifumi; Niinomi, Takuro; Ito, Takanori; Sone, Yoshitsugu; Kikuchi, Yuji; Maeda, Atsuyuki

doi:10.1016/j.jhep.2013.01.030

Cited by 70 publications

(59 citation statements)

References 27 publications

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“…In contrast to other types of early cancer (4,5), multicentric hepatocarcinogenesis in the remnant liver could not be avoided after surgery in patients with early HCC, and half of the patients who underwent liver resection for early HCC had recurrence within 4 years. Consistent with our data, previous studies have reported that the presence of hypovascular nodules at resection for hypervascular HCC is a risk factor for postoperative recurrence, which may be mainly ascribed to multicentric hepatocarcinogenesis (11,22). Furthermore,~40% of second primary HCCs arising after resection of early HCCs could not be treated curatively, and the development of a second primary HCC was an important prognostic factor, which supports our contention that treatment of early HCC did not beneficially alter the prognosis of patients and is not necessarily required immediately (8).…”

Section: Discussionsupporting

confidence: 92%

“…Similarly, several researchers have reported that preclinical phase HCC could be observed because of bias in length of time (9), that other classical HCC may appear even after complete removal of early HCC (10,11) and that the outcomes of early HCC depend on the underlying liver disease or the subsequent development of classical HCC (12,13).…”

Section: Introductionmentioning

confidence: 98%

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Early hepatocellular carcinoma as a signaling lesion for subsequent malignancy

Midorikawa¹,

Takayama²,

Higaki³

et al. 2016

Japanese Journal of Clinical Oncology

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Objective: Early diagnosis and treatment of cancer may contribute substantially to complete cure, but it remains unknown whether treatment of early hepatocellular carcinoma can actually result in cure. This study was performed to clarify the cancer risk of the background liver after treating early hepatocellular carcinoma. Methods: Early hepatocellular carcinoma is defined as very well-differentiated cancer containing Glisson's triad. The cumulative incidence of classical hepatocellular carcinoma, hypervascular liver cancer detected on imaging studies, after resection of early hepatocellular carcinoma positive for anti-hepatitis C antibody (early hepatocellular carcinoma group, n = 105) was compared with that in patients with chronic liver disease positive for anti-hepatitis C antibody (control group, n = 751) and propensity score-matched patients after resection of classical hepatocellular carcinoma (classical hepatocellular carcinoma group, n = 105). Results: After a median follow-up of 4.8 years (range, 0.3-15.0), the cumulative incidence of classical hepatocellular carcinoma at 5 years was 56.9% (95% confidence interval, 44.2-67.7%) in the early hepatocellular carcinoma group and 70.6% (52.5-81.8%) in the classical hepatocellular carcinoma group as compared with 4.6% (2.8-6.4%) in the control group. The risk of the development of classical hepatocellular carcinoma in the early hepatocellular carcinoma group was significantly higher than that in the control group (hazard ratio, 17.5; 95% confidence interval, 12.1-25.3; P < 0.001) and significantly lower than that in the classical hepatocellular carcinoma group (hazard ratio, 0.60; 0.41-0.89; P = 0.010). However, the cumulative incidence of second primary hepatocellular carcinoma in patients with one early hepatocellular carcinoma did not differ significantly from that in patients with two or more early hepatocellular carcinoma lesions (hazard ratio, 1.50; 0.85-2.65; P = 0.157). Conclusions: Treatment of early hepatocellular carcinoma cannot provide complete cure due to the substantial risk of developing classical hepatocellular carcinoma.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 98%

Early hepatocellular carcinoma as a signaling lesion for subsequent malignancy

Midorikawa¹,

Takayama²,

Higaki³

et al. 2016

Japanese Journal of Clinical Oncology

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“…They probably should not be ignored, however. In one study of patients who underwent resection for HCC, the presence of such nodules in the unresected liver remnant was a strong predictor of postoperative multicentric recurrence (99).…”

Section: Feature Commentsmentioning

confidence: 99%

CT and MR Imaging Diagnosis and Staging of Hepatocellular Carcinoma: Part II. Extracellular Agents, Hepatobiliary Agents, and Ancillary Imaging Features

Choi¹,

Lee²,

Sirlin³

2014

Radiology

456

385

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Computed tomography (CT) and magnetic resonance (MR) imaging play critical roles in the diagnosis and staging of hepatocellular carcinoma (HCC). The second article of this two-part review discusses basic concepts of diagnosis and staging, reviews the diagnostic performance of CT and MR imaging with extracellular contrast agents and of MR imaging with hepatobiliary contrast agents, and examines in depth the major and ancillary imaging features used in the diagnosis and characterization of HCC.q RSNA, 2014

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“…It is now known that when such nodules follow their natural course, many eventually become hypervascular and progress to classical hypervascular HCC [33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51]. For these reasons, it has recently become a reality in the diagnosis of early HCC that among existing imaging diagnostic modalities, EOB-MRI is achieving a level of diagnostic performance approaching that of liver pathology experts.…”

Section: Establishment Of the Concept Of Early Hccmentioning

confidence: 99%

Surveillance, Diagnosis, Treatment, and Outcome of Liver Cancer in Japan

Kudo¹

2015

Liver Cancer

184

136

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Background: Hepatocellular carcinoma (HCC) is the fifth most common type of cancer and the third leading cause of cancer-related death worldwide. HCC is most common in Asia, but its prevalence is rapidly increasing in Western countries; consequently, HCC is a global medical issue that urgently needs to be addressed. Japan is the only developed country that has experienced both hepatitis B-related and hepatitis C-related HCC and has a long history of innovation when it comes to new diagnostic and therapeutic modalities, such as computed tomography angiography, anatomical resection, ablation, and transarterial chemoembolization. Among these innovations, a nationwide surveillance program was well established by the 1980s, and such a long-term national program does not exist anywhere else in the world. Summary: More than 60% of the initially detected HCCs in Japan are Barcelona Clinic Liver Cancer stage 0 or A, which can undergo curative therapies such as resection, ablation, or transplantation. The recent 5-year survival rate of HCC patients in Japan was 43% and the median survival time was 50 months. In addition, both incidence and mortality rates are drastically declining as a result of the successful surveillance program, careful diagnostic flow, and extensive repeated treatments. Key Message: Japan's successful model in the surveillance, diagnosis, and treatment of HCC should be adopted as widely as possible to improve the survival of HCC patients worldwide.

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Non-hypervascular hypointense nodules detected by Gd-EOB-DTPA-enhanced MRI are a risk factor for recurrence of HCC after hepatectomy

Cited by 70 publications

References 27 publications

Early hepatocellular carcinoma as a signaling lesion for subsequent malignancy

Early hepatocellular carcinoma as a signaling lesion for subsequent malignancy

CT and MR Imaging Diagnosis and Staging of Hepatocellular Carcinoma: Part II. Extracellular Agents, Hepatobiliary Agents, and Ancillary Imaging Features

Surveillance, Diagnosis, Treatment, and Outcome of Liver Cancer in Japan

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