Preoperative gadoxetic Acid-enhanced MRI and simultaneous treatment of early hepatocellular carcinoma prolonged recurrence-free survival of progressed hepatocellular carcinoma patients after hepatic resection.
Background/Purpose. The purpose of this study was to clarify whether preoperative gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) and simultaneous treatment of suspected early hepatocellular carcinoma (eHCC) at the time of resection for progressed HCC affected patient prognosis following hepatic resection. Methods. A total of 147 consecutive patients who underwent their first curative hepatic resection for progressed HCC were enrolled. Of these, 77 patients underwent EOB-MRI (EOB-MRI (+)) before hepatic resection and the remaining 70 patients did not (EOB-MRI (-)). Suspected eHCCs detected by preoperative imaging were resected or ablated at the time of resection for progressed HCC. Results. The number of patients who underwent treatment for eHCCs was significantly higher in the EOB-MRI (+) than in the EOB-MRI (-) (17 versus 6; P = 0.04). Recurrence-free survival (1-, 3-, and 5-year; 81.4, 62.6, 48.7% versus 82.1, 41.5, 25.5%, resp., P < 0.01), but not overall survival (1-, 3-, and 5-year; 98.7, 90.7, 80.8% versus 97.0, 86.3, 72.4%, resp., P = 0.38), was significantly better in the EOB-MRI (+). Univariate and multivariate analyses showed that preoperative EOB-MRI was one of the independent factors significantly correlated with better recurrence-free survival. Conclusions. Preoperative EOB-MRI and simultaneous treatment of eHCC prolonged recurrence-free survival after hepatic resection.
First Department of Surgery, Yamanashi University School of Medicine, 1110 Shimokato, Chuo City, Yamanashi 409-3898, Japan.
Masanori
M
Matsuda
Department of Radiology, Yamanashi University School of Medicine, 1110 Shimokato, Chuo City, Yamanashi 409-3898, Japan.
Tomoaki
T
Ichikawa
First Department of Surgery, Yamanashi University School of Medicine, 1110 Shimokato, Chuo City, Yamanashi 409-3898, Japan.
Hidetake
H
Amemiya
First Department of Surgery, Yamanashi University School of Medicine, 1110 Shimokato, Chuo City, Yamanashi 409-3898, Japan.
Akira
A
Maki
First Department of Surgery, Yamanashi University School of Medicine, 1110 Shimokato, Chuo City, Yamanashi 409-3898, Japan.
Mitsuaki
M
Watanabe
First Department of Surgery, Yamanashi University School of Medicine, 1110 Shimokato, Chuo City, Yamanashi 409-3898, Japan.
Hiromichi
H
Kawaida
First Department of Surgery, Yamanashi University School of Medicine, 1110 Shimokato, Chuo City, Yamanashi 409-3898, Japan.
Hiroshi
H
Kono
Department of Radiology, Yamanashi University School of Medicine, 1110 Shimokato, Chuo City, Yamanashi 409-3898, Japan.
Katsuhiro
K
Sano
Department of Radiology, Yamanashi University School of Medicine, 1110 Shimokato, Chuo City, Yamanashi 409-3898, Japan.
Utaroh
U
Motosugi
First Department of Surgery, Yamanashi University School of Medicine, 1110 Shimokato, Chuo City, Yamanashi 409-3898, Japan.
Hideki
H
Fujii