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Peritumoral edema in preoperative magnetic resonance imaging is an independent prognostic factor for hepatocellular carcinoma

  • Author Footnotes
    1 The contributions of the authors are equal.
    Hai-Lu He
    Footnotes
    1 The contributions of the authors are equal.
    Affiliations
    Department of Radiology, Tumor Hospital, Guangxi Medical University, No. 71 Hedi Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China
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  • Author Footnotes
    1 The contributions of the authors are equal.
    Qiang Wang
    Footnotes
    1 The contributions of the authors are equal.
    Affiliations
    Department of Anesthesia, Tumor Hospital, Guangxi Medical University, No. 71 Hedi Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China
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  • Lu Liu
    Affiliations
    Department of Radiology, Tumor Hospital, Guangxi Medical University, No. 71 Hedi Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China
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  • Ning-Bin Luo
    Affiliations
    Department of Radiology, Tumor Hospital, Guangxi Medical University, No. 71 Hedi Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China
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  • Dan-Ke Su
    Correspondence
    Correspondence to: D.-K. Su, Department of Radiology, Tumor Hospital, Guang xi Medical University, Nan ning, China.
    Affiliations
    Department of Radiology, Tumor Hospital, Guangxi Medical University, No. 71 Hedi Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China
    Search for articles by this author
  • Guan-Qiao Jin
    Correspondence
    Correspondence to: G.-Q. Jin, Department of Radiology, Radiology, Tumor Hospital, Guang xi Medical University, No. 71 Hedi Road, Nanning City, Guangxi Zhuang Autonomous Region, China.
    Affiliations
    Department of Radiology, Tumor Hospital, Guangxi Medical University, No. 71 Hedi Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China
    Search for articles by this author
  • Author Footnotes
    1 The contributions of the authors are equal.

      Highlights

      • The occurrence of peritumoral edema is more progressive and prone to recurrence.
      • Peritumoral edema is an prognostic factor for hepatocellular carcinoma.
      • Magnetic resonance imaging can better observation of peritumoral edema.
      • Can provide prognostic value for patients with hepatocellular carcinoma.

      Abstract

      Background

      Peritumoral edema is an independent prognostic risk factor for malignant tumors. Therefore, assessment of peritumoral edema in preoperative magnetic resonance imaging (MRI) may provide better prognostic information in patients with hepatocellular carcinoma (HCC).

      Aim

      To determine whether peritumoral edema in preoperative MRI is a prognostic factor for HCC.

      Methods

      A retrospective analysis of 90 patients with HCC confirmed by surgical pathology was performed. All patients' peritumoral edema in preoperative MRI was reviewed by two radiologists. The association of disease recurrence with peritumoral edema and clinicopathological features was assessed using the Cox proportional hazards model. Interobserver agreement for evaluating peritumoral edema was determined using Cohen's κ coefficient.

      Results

      Recurrence and non-recurrence after an average 20.8 month follow-up was 25.6% (23/90) and 74.4% (67/90), respectively. The ratio of peritumoral edema of 90 patients with HCC in preoperative MRI was 35.6% (32/90). In univariate Cox regression analysis, peritumoral edema [hazard ratio (HR) 11.08, P < 0.001], tumor diameter (HR 4.12, P = 0.001), microvascular invasion (HR 2.78, P = 0.020), gender (HR 0.29, P = 0.006), cirrhosis (HR 2.45, P = 0.049), ascites syndrome (HR 2.83, P = 0.022), aspartate aminotransferase(AST)/alanine aminotransferase(ALT) (HR 5.07, P = 0.003) were indicators for HCC recurrence. In multivariate Cox regression analysis, the tumor diameter (HR 2.53, P = 0.032) and peritumoral edema (HR 8.71, P < 0.001) were independent prognostic factors of HCC. The sensitivity, specificity, positive predictive value and negative predictive value of peritumoral edema and tumor diameter were 82.6%&60.9%, 80.6%&77.6%, 59.4%&48.3%, and 93.1%&85.3%, respectively.

      Conclusion

      Peritumoral edema in preoperative MRI may be considered as a biomarker of prognostic information for patients with HCC.

      Keywords

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