Abstract:
Objective: To assess the value of preoperative clinical data and magnetic resonance (MR) imaging features in predicting early recurrence (recurrence in two years) after surgical resection of hepatocellular carcinoma (HCC).
Methods: This retrospective studyincluded 244 patients with HCC who underwent a surgical resection between January 2015 and January 2018 at Tianjin Medical University Cancer Institute and Hospital. The role of preoperative clinical data and MR imaging features on early recurrence after surgicaltumor resection were evaluated using univariate and multivariate analyses. All patients were followed up regularly after discharge.The endpoint was considered to be intrahepatic recurrence within 2 years.
Results: In the univariate analyses, the maximum diameterof the tumor, tumor capsule, peritumoral parenchyma enhancement, rim enhancement, two-trait predictor of venous invasion (TTPVI), tumor necrosis, satellite nodules, dynamic enhancement pattern, diffusion-weighted imaging (DWI) /T2WI mismatch and otherMR imaging features, as well as alpha-fetoprotein (AFP), TNM stage, alanine aminotransferase (ALT), glutamatergic aminotransferase(AST), direct bilirubin (DBIL), γ-glutamyl transferase (γ-GT) and other clinical data were correlated with the early recurrence of HCC. Inthe multivariate Cox regression analysis, the tumor capsule (HR=0.372, P < 0.05), rim enhancement (HR=2.947, P < 0.05), TTPVI (HR=1.993, P=0.004), satellite nodules (HR=2.192, P=0.017) and AFP > 400 μg/L (HR=2.234, P < 0.05) were independent factors of early recurrence after surgical resection of HCC. According to the results of the multivariate Cox regression analysis, a nomogram can be drawn tointuitively show the risk of recurrence.
Conclusions: MRI features like tumor capsule, rim enhancement, TTPVI, satellite nodules, and AFP > 400 μg/L were found to be independent factors of the early postoperative recurrence of HCC. This research has established a predictive model for the early recurrence of HCC after surgical resection using a non-invasive method, which can help clinicians to develop individualized treatment protocols and improve patient outcomes.