RESUMEN
PURPOSE: Retrospective evaluation of intermediate-stage hepatocellular carcinoma (HCC) patient survival after undergoing chemoembolization based on the Child-Pugh score. MATERIALS AND METHODS: Data of intermediate-stage HCC patients undergoing chemoembolization were gathered from 43 centers in Japan. Overall survival rates were compared with Child-Pugh scores. RESULTS: Of the 329 patients examined in this study, Child-Pugh scores were 5 (CP-5) in 136 patients (41.3%), 6 (CP-6) in 101 patients (30.7%), 7 (CP-7) in 58 (17.7%), 8 (CP-8) in 22 (6.7%), and 9 (CP-9) in 12 (3.6%). Two-year survival rates were 77.5% in CP-5 patients (p = 0.047 vs. CP-6), 65.1% in CP-6 patients (p = 0.038 vs. CP-7), 51.3% in CP-7 patients (p = 0.30 vs. CP-8, p = 0.034 vs. CP-9), 50.3% in CP-8 patients (p = 0.0065 vs. CP-9), and 16.7% in CP-9 patients. Two-year survival rates were 77.2% in 139 patients meeting the 4 tumors of 7 cm criterion with Child-Pugh class A (B1) (p < 0.0001 vs. B2), 59.5% in 178 patients other than B1 and B3 (B2) (p = 0.0014 vs. B3), and 16.7% in 12 patients with Child-Pugh score 9 (B3). CONCLUSION: The Child-Pugh score is a useful prognostic factor to stratify intermediate-stage HCC patients.
Asunto(s)
Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/patología , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/patología , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma Hepatocelular/terapia , Quimioembolización Terapéutica/métodos , Femenino , Humanos , Japón , Hígado/diagnóstico por imagen , Hígado/patología , Neoplasias Hepáticas/terapia , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Pronóstico , Estudios Retrospectivos , Tasa de Supervivencia , Tomografía Computarizada por Rayos X/métodos , UltrasonografíaRESUMEN
PURPOSE: To find a subgroup that benefits most from transarterial chemoembolization (TACE) in terms of tumor number and size and liver profile in patients with intermediate-stage hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Data of 325 intermediate-stage HCC patients who received TACE as the initial treatment were gathered. Four tumor numbers (3-6 tumors) and five maximum tumor diameters (3-7 cm) as well as all of their combinations but one (3 tumors and 3 cm) and Child-Pugh grade were used as variables to ascertain prognostic factors. RESULTS: The respective 1-, 3-, and 5-year overall survival rates in all patients were 86.5, 47.0, and 23.7%, respectively. Tumor numbers of 4 (P = 0.00145) and 5 (P = 0.036), and tumor size of 7 cm (P = 0.015), and 12 other combinations of tumor number and size, and Child-Pugh grade (P = 0.0015) were identified as significant prognostic factors in univariate analysis, and 4 tumors of 7 cm (P = 0.0008) and Child-Pugh grade (P = 0.0036) remained significant in the stepwise Cox proportional hazard model. The overall survival was significantly better in a patient subgroup having two factors other than patient subgroups having one or no prognostic factors. CONCLUSION: A patient subgroup having two prognostic factors benefited most from TACE in intermediate-stage HCC patients.
Asunto(s)
Carcinoma Hepatocelular/patología , Carcinoma Hepatocelular/terapia , Quimioembolización Terapéutica , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/terapia , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Estadificación de Neoplasias , Pronóstico , Tasa de Supervivencia , Resultado del Tratamiento , Carga TumoralRESUMEN
PURPOSE: To evaluate retrospectively whether technical factors of hepatic arterial embolization affect the prognosis of patients with hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Inclusion criteria of this study were the following: (1) patients received embolization as the initial treatment during 2003-2004, (2) Child A or B liver profile, (3) five or fewer HCCs with maximum diameter of 7 cm or smaller, and (4) no extrahepatic metastasis. Patient data were gathered from 43 centers. Prognostic factors were evaluated using univariate and multivariate analyses. RESULTS: Eight hundred fifteen patients were enrolled. The 1-, 3-, 5-, and 7-year overall survival rates were 92.0 % (95 % CI 90.1-93.9), 62.9 % (95 % CI 59.3-66.6), 39.0 % (95 % CI 35.1-43.0), and 26.7 % (95 % CI 22.6-30.8) in all patients. Univariate analysis showed a Child-Pugh class-A, alpha-fetoprotein level lower than 100 ng/ml, tumor size of 3 cm or smaller, tumor number of 3 or fewer, one-lobe tumor distribution, nodular tumor type, within the Milan criteria, stage I or II, no portal venous invasion, use of iodized oil, and selective embolization were significantly better prognostic factors. In the multivariate Cox model, the benefit to survival of selective embolization remained significant (hazard ratio 0.68; 95 % CI 0.48-0.97; p = 0.033). CONCLUSION: Selective embolization contributes to survival in patients with HCCs.
Asunto(s)
Carcinoma Hepatocelular/terapia , Quimioembolización Terapéutica/métodos , Neoplasias Hepáticas/terapia , Adulto , Anciano , Anciano de 80 o más Años , Progresión de la Enfermedad , Femenino , Arteria Hepática , Humanos , Aceite Yodado/administración & dosificación , Masculino , Persona de Mediana Edad , Pronóstico , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Tasa de Supervivencia , alfa-Fetoproteínas/análisisRESUMEN
We evaluated clinical usefulness of MD online Image Match with the clinical images of 70 intracranial lesions. Total diagnostic accuracy and image similarity between the clinical image and search results was better with enhanced-T1WI. In all sequence, localization was matched precisely in more than 90% of cases. MDOL Image Match was thought to be useful for enhancing the quality of brain MRI diagnosis.