title: CT with hepatic arterioportography as a pretreatment examination for hepatocellular carcinoma patients: a randomized controlled trial.
abstract: OBJECTIVE
  The combination of computed tomography with hepatic arteriography and arterial portography (CTHA/CTAP) can detect additional hepatocellular carcinoma (HCC) nodules undetected by conventional dynamic CT.
  
  
  METHODS
  In this single-center, randomized, open-label, controlled trial, we randomly assigned 280 patients who were diagnosed as having HCC by conventional dynamic CT, and eligible for radiofrequency ablation (RFA), to undergo CTHA/CTAP before treatment, or to the control group. Newly detected HCC nodules by CTHA/CTAP were intended to be ablated completely. The primary end point was recurrence-free survival and the key secondary end point was overall survival. The analysis was conducted on an intention-to-treat basis. Those with nonablated nodules were treated as for recurrence.
  
  
  RESULTS
  A total of 75 nodules were newly diagnosed as HCC by CTHA/CTAP in 45 patients. Three patients (one in the CTHA/CTAP group and two in the control group) who refused treatment were excluded from all analyses. The cumulative recurrence-free survival rates at 1, 2, and 3 years were 60.1, 29.0, and 18.9% in the CTHA/CTAP group and 52.2, 29.7, and 23.1% in the control group, respectively (P=0.66 by log-rank test; hazard ratio, 0.94 for CTHA/CTAP vs. control; 95% confidence interval (CI), 0.73-1.22). The cumulative overall survival rates at 3 and 5 years were 79.7 and 56.4% in the CTHA/CTAP group and 86.8 and 60.1% in the control group, respectively (P=0.50; hazard ratio, 1.15, 95% CI, 0.77-1.71).
  
  
  CONCLUSIONS
  CTHA/CTAP may detect recurrent lesions earlier. However, CTHA/CTAP before RFA did not improve cumulative recurrence-free survival or overall survival.
authors: Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors: Takamasa
authors: T
authors: Ohki
authors: Ryosuke
authors: R
authors: Tateishi
authors: Masaaki
authors: M
authors: Akahane
authors: Shintaro
authors: S
authors: Mikami
authors: Masaya
authors: M
authors: Sato
authors: Koji
authors: K
authors: Uchino
authors: Toru
authors: T
authors: Arano
authors: Kenichiro
authors: K
authors: Enooku
authors: Yuji
authors: Y
authors: Kondo
authors: Noriyo
authors: N
authors: Yamashiki
authors: Tadashi
authors: T
authors: Goto
authors: Shuichiro
authors: S
authors: Shiina
authors: Haruhiko
authors: H
authors: Yoshida
authors: Yutaka
authors: Y
authors: Matsuyama
authors: Masao
authors: M
authors: Omata
authors: Kuni
authors: K
authors: Ohtomo
authors: Kazuhiko
authors: K
authors: Koike
mesh_terms: D000368:Aged; D000792:Angiography / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000628:therapy; D017115:Catheter Ablation; D003287:Contrast Media; D018450:Disease Progression; D004621:Embolization, Therapeutic; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011172:Portography / Q000379:methods*; D016016:Proportional Hazards Models; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media
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