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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Article info
Publication history
Published online: January 19, 2021
Accepted:
January 17,
2021
Received in revised form:
January 2,
2021
Received:
August 23,
2020
Identification
Copyright
© 2021 Published by Elsevier Inc.
