Radiographic features of hepatocellular carcinoma and their relation to prognosis in Canada.
To determine the radiographic features of hepatocellular carcinoma (HCC) as seen in Canada and their relation to prognosis, multiple imaging studies for 40 patients with histologically proven HCC were reviewed. The patients, 34 men and 6 women ranging in age from 43 to 86 years, were selected from a larger database on the basis of the availability of ultrasound (US) images and at least one other imaging study. The patients had been examined between 1981 and 1991 at a tertiary-care hospital. In 35 of the 40 cases (88%) HCC had been detected by US assessment, the criterion for complete analysis, but in one of those cases the lesion was not observed in the initial scans. HCC was detected by computed tomography (CT) in the 27 cases in which that technique had been used. Cirrhosis was present in 27 of the 35 patients (77%) for which a complete analysis was performed. Median survival after diagnosis for all 40 patients was 14.1 weeks. Seven radiographic features were analysed for prognostic value by univariate and multivariate (Cox) regression analysis. However, the regression analysis indicated no relation between survival and tumour size, the nature of the tumour (diffuse and infiltrative or discrete), vascular involvement, encapsulation, extrahepatic spread, tumour location or echogenicity. No radiographic feature, including tumour size, correlated with the serum level of alpha-fetoprotein, which was elevated in 23 of the 32 cases (72%) in which it had been determined. These results confirm the variable radiographic appearance of HCC but differ in other respects from those reported previously, particularly those for studies performed outside North America.(ABSTRACT TRUNCATED AT 250 WORDS)
Salonen
D C
DC
Department of Diagnostic Imaging, University of Toronto, North York, Ont.
Leonhardt
C M
CM
Hemphill
D
D
Hanna
S S
SS
Pappas
S C
SC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D002170:Canada; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary / Q000601:surgery; D005260:Female; D005710:Gallium Radioisotopes; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D011877:Radionuclide Imaging; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D000509:alpha-Fetoproteins / Q000032:analysis
D005710:Gallium Radioisotopes; D000509:alpha-Fetoproteins