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Curative Resection of Single Primary Hepatic Malignancy: Liver Imaging Reporting and Data System Category LR-M Portends a Worse Prognosis

Authors
 Chansik An  ;  Sumi Park  ;  Yong Eun Chung  ;  Do-Young Kim  ;  Seung-seob Kim  ;  Myeong-Jin Kim  ;  Jin-Young Choi 
Citation
 American Journal of Roentgenology, Vol.209(3) : 576-583, 2017 
Journal Title
 American Journal of Roentgenology 
ISSN
 0361-803X 
Issue Date
2017
MeSH
Adult Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/diagnostic imaging* ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/surgery* ; Cholangiocarcinoma/diagnostic imaging* ; Cholangiocarcinoma/pathology ; Cholangiocarcinoma/surgery* ; Contrast Media ; Female ; Gadolinium DTPA ; Humans ; Image Interpretation, Computer-Assisted ; Liver Neoplasms/diagnostic imaging* ; Liver Neoplasms/pathology ; Liver Neoplasms/surgery* ; Magnetic Resonance Imaging/methods* ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Prognosis ; Retrospective Studies ; Survival Rate ; Treatment Outcome
Keywords
Liver Imaging Reporting and Data System (LI-RADS) ; MRI ; gadoxetic acid ; hepatocellular carcinoma ; prognosis
Abstract
OBJECTIVE: The purpose of this study was to examine the associations between preoperative Liver Imaging Reporting and Data System (LI-RADS) categories and prognosis after curative resection of single hepatic malignancies in patients with chronic liver disease. MATERIALS AND METHODS: Between January 2008 and December 2010, 225 patients with chronic liver disease underwent resection of single hepatic malignant tumors (218 hepatocellular carcinomas, three cholangiocarcinomas, four biphenotypic carcinomas) after undergoing gadoxetic acid-enhanced MRI. Two radiologists retrospectively categorized the tumors into LI-RADS categories. Differences in disease-free survival duration between categories were analyzed by the Kaplan-Meier method with the log-rank test. RESULTS: Reviewer 1 categorized two (0.9%) patients as having LR-3, 53 (23.6%) LR-4, 159 (70.7%) LR-5, and 11 (4.9%) LR-M lesions. The corresponding numbers for reviewer 2 were six (2.7%) LR-3, 30 (13.3%) LR-4, 178 (79.1%) LR-5, and 11 (4.9%) LR-M. The 2-year cumulative recurrence or death rates were 15.1% for lesions categorized LR-3 or LR-4 by reviewer 1, 31.7% for LR-5, and 60% for LR-M. For lesions categorized by reviewer 2 the corresponding rates were 20.6% for LR-3 or LR-4, 29% for LR-5, and 54.5% for LR-M. Disease-free survival was significantly worse among patients with lesions categorized as LR-M than for lesions categorized as LR-3 or LR-4 or as LR-5 (p < 0.01 for both reviewers). Disease-free survival did not significantly differ between patients with LR-3 or LR-4 and those with LR-5 lesions (reviewer 1, p = 0.301; reviewer 2, p = 0.291). CONCLUSION: Patients with tumors preoperatively categorized as LR-M may have a worse prognosis than those with tumors categorized LR-3, LR-4, or LR-5 after curative resection of single hepatic malignancy.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161125
DOI
10.2214/AJR.16.17478
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
Yonsei Authors
김도영(Kim, Do Young) ; 김명진(Kim, Myeong Jin) ; 김승섭(Kim, Seung-seob) ; 안찬식(An, Chan Sik) ; 정용은(Chung, Yong Eun) ; 최진영(Choi, Jin Young)
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Full Text
https://www.ajronline.org/doi/abs/10.2214/AJR.16.17478
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