Local recurrence of hepatocellular carcinoma after segmental transarterial chemoembolization: risk estimates based on multiple prognostic factors.
OBJECTIVE
To determine the prognostic factors for local recurrence of nodular hepatocellular carcinoma after segmental transarterial chemoembolization.


METHODS
Seventy-four nodular hepatocellular carcinoma tumors < or = 5 cm were retrospectively analyzed for local recurrence after segmental transarterial chemoembolization using follow-up CT images (median follow-up of 17 months, 4-77 months in range). The tumors were divided into four groups (IA, IB, IIA, and IIB) according to whether the one-month follow-up CT imaging, after segmental transarterial chemoembolization, showed homogeneous (Group I) or inhomogeneous (Group II) iodized oil accumulation, or whether the tumors were located within the liver segment (Group A) or in a segmental border zone (Group B). Comparison of tumor characteristics between Group IA and the other three groups was performed using the chi-square test. Local recurrence rates were compared among the groups using the Kaplan-Meier estimation and log rank test.


RESULTS
Local tumor recurrence occurred in 19 hepatocellular carcinoma tumors (25.7%). There were: 28, 18, 17, and 11 tumors in Group IA, IB, IIA, and IIB, respectively. One of 28 (3.6%) tumors in Group IA, and 18 of 46 (39.1%) tumors in the other three groups showed local recurrence. Comparisons between Group IA and the other three groups showed that the tumor characteristics were similar. One-, two-, and three-year estimated local recurrence rates in Group IA were 0%, 11.1%, and 11.1%, respectively. The difference between Group IA and the other three groups was statistically significant (p = 0.000).


CONCLUSIONS
An acceptably low rate of local recurrence was observed for small or intermediate nodular tumors located within the liver segment with homogeneous iodized oil accumulation.
Park
Seung Hyun
SH
Department of Radiology, Seoul Veterans Hospital, Gangdong-Gu, Seoul, Korea.
Cho
Yun Ku
YK
Ahn
Yong-Sik
YS
Park
Yoon-Ok
YO
Kim
Jae Kyun
JK
Chung
Jin Wook
JW
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
D007459:Iodized Oil