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

 Chansik An  ;  Sumi Park  ;  Yong Eun Chung  ;  Do-Young Kim  ;  Seung-seob Kim  ;  Myeong-Jin Kim  ;  Jin-Young Choi 
 AMERICAN JOURNAL OF ROENTGENOLOGY, Vol.209(3) : 576-583, 2017 
Journal Title
Issue Date
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
Liver Imaging Reporting and Data System (LI-RADS) ; MRI ; gadoxetic acid ; hepatocellular carcinoma ; prognosis
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.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Kim, Seung-seob(김승섭) ORCID logo https://orcid.org/0000-0001-6071-306X
An, Chansik(안찬식) ORCID logo https://orcid.org/0000-0002-0484-6658
Chung, Yong Eun(정용은) ORCID logo https://orcid.org/0000-0003-0811-9578
Choi, Jin Young(최진영) ORCID logo https://orcid.org/0000-0002-9025-6274
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