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From LI-RADS Classification to HCC Pathology: A Retrospective Single-Institution Analysis of Clinico-Pathological Features Affecting Oncological Outcomes after Curative Surgery.
Centonze, Leonardo; De Carlis, Riccardo; Vella, Ivan; Carbonaro, Luca; Incarbone, Niccolò; Palmieri, Livia; Sgrazzutti, Cristiano; Ficarelli, Alberto; Valsecchi, Maria Grazia; Dello Iacono, Umberto; Lauterio, Andrea; Bernasconi, Davide; Vanzulli, Angelo; De Carlis, Luciano.
Afiliación
  • Centonze L; Department of General Surgery and Transplantation, Niguarda Ca' Granda Hospital, 20161 Milan, Italy.
  • De Carlis R; Department of General Surgery and Transplantation, Niguarda Ca' Granda Hospital, 20161 Milan, Italy.
  • Vella I; Department of General Surgery and Transplantation, Niguarda Ca' Granda Hospital, 20161 Milan, Italy.
  • Carbonaro L; Department of Diagnostic and Interventional Radiology, Niguarda Ca' Granda Hospital, 20161 Milan, Italy.
  • Incarbone N; Department of General Surgery and Transplantation, Niguarda Ca' Granda Hospital, 20161 Milan, Italy.
  • Palmieri L; Department of General Surgery and Transplantation, Niguarda Ca' Granda Hospital, 20161 Milan, Italy.
  • Sgrazzutti C; Department of Diagnostic and Interventional Radiology, Niguarda Ca' Granda Hospital, 20161 Milan, Italy.
  • Ficarelli A; Department of General Surgery and Transplantation, Niguarda Ca' Granda Hospital, 20161 Milan, Italy.
  • Valsecchi MG; Bicocca Bioinformatics Biostatistics and Bioimaging Centre-B4, School of Medicine and Surgery, University of Milan-Bicocca, 20126 Milan, Italy.
  • Dello Iacono U; Department of Diagnostic and Interventional Radiology, Niguarda Ca' Granda Hospital, 20161 Milan, Italy.
  • Lauterio A; Department of General Surgery and Transplantation, Niguarda Ca' Granda Hospital, 20161 Milan, Italy.
  • Bernasconi D; Bicocca Bioinformatics Biostatistics and Bioimaging Centre-B4, School of Medicine and Surgery, University of Milan-Bicocca, 20126 Milan, Italy.
  • Vanzulli A; Department of Diagnostic and Interventional Radiology, Niguarda Ca' Granda Hospital, 20161 Milan, Italy.
  • De Carlis L; Department of General Surgery and Transplantation, Niguarda Ca' Granda Hospital, 20161 Milan, Italy.
Diagnostics (Basel) ; 12(1)2022 Jan 10.
Article en En | MEDLINE | ID: mdl-35054327
ABSTRACT

Background:

The latest Liver Imaging Reporting and Data System (LI-RADS) classification by the American College of Radiology has been recently endorsed in the American Association for the Study of Liver Disease (AASLD) guidelines for Hepatocellular carcinoma (HCC) management. Although the LI-RADS protocol has been developed as a diagnostic algorithm, there is some evidence concerning a possible correlation between different LI-RADS classes and specific pathological features of HCC. We aimed to investigate such radiological/pathological correlation and the possible prognostic implication of LI-RADS on a retrospective cohort of HCC patients undergoing surgical resection.

Methods:

We performed a retrospective analysis of the pathological characteristics of resected HCC, exploring their distribution among different LI-RADS classes and analyzing the risk factors for recurrence-free, overall and cancer-specific survival

Results:

LI-RADS-5 (LR-5) nodules showed a higher prevalence of microvascular invasion (MVI), satellitosis and capsule infiltration, as well as higher median values of alpha-fetoprotein (αFP) compared to LI-RADS-3/4 (LR-3/4) nodules. MVI, αFP, satellitosis and margin-positive (R1) resection resulted as independent risk factors for recurrence-free survival, while LI-RADS class did not exert any significant impact. Focusing on overall survival, we identified patient age, Eastern Cooperative Oncology Group performance status (ECOG-PS), Model for End Stage Liver Disease (MELD) score, αFP, MVI, satellitosis and R1 resection as independent risk factors for survival, without any impact of LI-RADS classification. Last, MELD score, log10αFP, satellitosis and R1 resection resulted as independent risk factors for cancer-specific survival, while LI-RADS class did not exert any significant impact.

Conclusions:

Our results suggest an association of LR-5 class with unfavorable pathological characteristics of resected HCC; tumor histology and underlying patient characteristics such as age, ECOG-PS and liver disease severity exert a significant impact on postoperative oncological outcomes.
Palabras clave

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Tipo de estudio: Guideline / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Diagnostics (Basel) Año: 2022 Tipo del documento: Article País de afiliación: Italia

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Tipo de estudio: Guideline / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Diagnostics (Basel) Año: 2022 Tipo del documento: Article País de afiliación: Italia