Combined hepatocellular-cholangiocarcinoma: can we use contrast-enhanced ultrasound Liver Imaging Reporting and Data System (LI-RADS) to predict the patient’s survival?
Objectives To evaluate the relationship between contrast-enhanced (CE) ultrasound Liver Reporting and Data System (LI-RADS) classification of combined hepatocellular-cholangiocarcinoma (cHCC-CCA) and their histopathological component predominance, and to determine if the CEUS LI-RADS category can be...
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| Veröffentlicht in: | European radiology 2021-08, Vol.31 (8), p.6397-6405 |
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| creator | Yang, Jie Huang, Jia-Yan Chen, Xing Ling, Wen-Wu Luo, Yan Shi, Yu-Jun Liu, Ji-Bin Lu, Qiang Lyshchik, Andrej |
| description | Objectives
To evaluate the relationship between contrast-enhanced (CE) ultrasound Liver Reporting and Data System (LI-RADS) classification of combined hepatocellular-cholangiocarcinoma (cHCC-CCA) and their histopathological component predominance, and to determine if the CEUS LI-RADS category can be used to predict the patient’s survival after surgical resection.
Methods
Between January 2011 and December 2018, medical records and CEUS of patients with pathologically proven cHCC-CCA were studied. The predominance of hepatocellular carcinoma (HCC)/intrahepatic cholangiocarcinoma (ICC) component of cHCC-CCA was analyzed by histopathology. The proportion of HCC-predominant cHCC-CCA in different LI-RADS category was compared by using Fisher’s exact test. Factors affecting tumor recurrence were analyzed by Cox proportional hazard model. Disease-free survival (DFS) was estimated by using Kaplan-Meier survival curve and compared by log-rank test.
Results
The study included 37 cHCC-CCA patients (33 men, 4 women; average age, 50.4 ± 11.0 years) and 37 nodules (mean diameter, 6.1 ± 3.9 cm). According to CEUS LI-RADS, 62.2% (23/37), 18.9% (7/37), and 18.9% (7/37) of cHCC-CCA were classified as LR-M, LR-5, and LR-TIV, respectively. The ratio of HCC predominance in LR-5 was 100% (10/10) vs 81.5% (22/27) in the LR-M group (
p
= 0.591). In our population, LR-5 patients had longer DFS than LR-M and LR-TIV patients combined (median DFS: 18.0 vs 6.4 months,
p
= 0.016). Multiple lesions (hazard ratio, 3.1;
p
= 0.007), tumor size (≥ 5 cm, hazard ratio, 4.1;
p
= 0.003), and CEUS LI-RADS category (LR-M and LR-TIV, hazard ratio, 4.7;
p
= 0.011) showed independent association with shorter DFS.
Conclusion
cHCC-CCA characterized as LR-5 on CEUS tend to represent HCC-predominant tumors with significantly longer disease-free survival compared to cHCC-CCA categorized as LR-M and LR-TIV.
Key Points
•
By using the American College of Radiology contrast-enhanced ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS), majority (30/37, 81.1%) of cHCC-CCA tumors were classified as LR-M or LR-TIV and only 18.9% (7/30) of cHCC-CCA were categorized as LR-5.
•
Patients with CEUS LR-5 cHCC-CCA had statistically significant longer disease-free time than those with LR-M and TIV cHCC-CCA (median DFS: 18.0 vs 6.4 months, p = 0.016).
•
Multiple lesions (hazard ratio, 3.1; p = 0.007), tumor size (≥ 5 cm, hazard ratio, 4.1; p = 0.003), and CEUS LI-RADS category (LR-M and LR-TIV, hazard ratio, |
| doi_str_mv | 10.1007/s00330-020-07656-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2480754346</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2549838235</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-e35f2801113fded6d82548dbfd226c9d67576eca11e008ef2200b32e6c05bb613</originalsourceid><addsrcrecordid>eNp9kUtuFDEQhlsIRIbABVggS2zCoqH86BebKJrwGGkkpATWlttdPeOo225s96DsuAZX4FicBDcTQGLBwrJV9dVfv_xn2VMKLylA9SoAcA45sHSqsihzei9bUcFZTqEW97MVNLzOq6YRJ9mjEG4AoKGiepidcC4aJipYZd_XbmyNxY7scVLRaRyGeVA-13s3KLszTiuvjXWjek20suQLkjkg0c5Gr0LM0e6V1Wl-HpaCm21HtuaAnmxGtTN2R65wcj4uL5V6lyoqcn0bIo7kbLvJry4ur1-Q6MjksTM6krhHkpwYtPHH12-BhNkfzEEN54-zB70aAj65u0-zT2_ffFy_z7cf3m3WF9tc86pIhnjRsxoopbzvsCu7mhWi7tq-Y6zUTVdWRVWiVpQiQI09YwAtZ1hqKNq2pPw0OzvqTt59njFEOZqw_Iuy6OYgmaihKgQXZUKf_4PeuNnb5E6mpU3Na8aLRLEjpb0LwWMvJ29G5W8lBbkkKY9JypSk_JWkXFw8u5Oe2xG7PyO_o0sAPwIhtewO_d_d_5H9CbMOq_E</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2549838235</pqid></control><display><type>article</type><title>Combined hepatocellular-cholangiocarcinoma: can we use contrast-enhanced ultrasound Liver Imaging Reporting and Data System (LI-RADS) to predict the patient’s survival?</title><source>Springer Nature - Complete Springer Journals</source><creator>Yang, Jie ; Huang, Jia-Yan ; Chen, Xing ; Ling, Wen-Wu ; Luo, Yan ; Shi, Yu-Jun ; Liu, Ji-Bin ; Lu, Qiang ; Lyshchik, Andrej</creator><creatorcontrib>Yang, Jie ; Huang, Jia-Yan ; Chen, Xing ; Ling, Wen-Wu ; Luo, Yan ; Shi, Yu-Jun ; Liu, Ji-Bin ; Lu, Qiang ; Lyshchik, Andrej</creatorcontrib><description>Objectives
To evaluate the relationship between contrast-enhanced (CE) ultrasound Liver Reporting and Data System (LI-RADS) classification of combined hepatocellular-cholangiocarcinoma (cHCC-CCA) and their histopathological component predominance, and to determine if the CEUS LI-RADS category can be used to predict the patient’s survival after surgical resection.
Methods
Between January 2011 and December 2018, medical records and CEUS of patients with pathologically proven cHCC-CCA were studied. The predominance of hepatocellular carcinoma (HCC)/intrahepatic cholangiocarcinoma (ICC) component of cHCC-CCA was analyzed by histopathology. The proportion of HCC-predominant cHCC-CCA in different LI-RADS category was compared by using Fisher’s exact test. Factors affecting tumor recurrence were analyzed by Cox proportional hazard model. Disease-free survival (DFS) was estimated by using Kaplan-Meier survival curve and compared by log-rank test.
Results
The study included 37 cHCC-CCA patients (33 men, 4 women; average age, 50.4 ± 11.0 years) and 37 nodules (mean diameter, 6.1 ± 3.9 cm). According to CEUS LI-RADS, 62.2% (23/37), 18.9% (7/37), and 18.9% (7/37) of cHCC-CCA were classified as LR-M, LR-5, and LR-TIV, respectively. The ratio of HCC predominance in LR-5 was 100% (10/10) vs 81.5% (22/27) in the LR-M group (
p
= 0.591). In our population, LR-5 patients had longer DFS than LR-M and LR-TIV patients combined (median DFS: 18.0 vs 6.4 months,
p
= 0.016). Multiple lesions (hazard ratio, 3.1;
p
= 0.007), tumor size (≥ 5 cm, hazard ratio, 4.1;
p
= 0.003), and CEUS LI-RADS category (LR-M and LR-TIV, hazard ratio, 4.7;
p
= 0.011) showed independent association with shorter DFS.
Conclusion
cHCC-CCA characterized as LR-5 on CEUS tend to represent HCC-predominant tumors with significantly longer disease-free survival compared to cHCC-CCA categorized as LR-M and LR-TIV.
Key Points
•
By using the American College of Radiology contrast-enhanced ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS), majority (30/37, 81.1%) of cHCC-CCA tumors were classified as LR-M or LR-TIV and only 18.9% (7/30) of cHCC-CCA were categorized as LR-5.
•
Patients with CEUS LR-5 cHCC-CCA had statistically significant longer disease-free time than those with LR-M and TIV cHCC-CCA (median DFS: 18.0 vs 6.4 months, p = 0.016).
•
Multiple lesions (hazard ratio, 3.1; p = 0.007), tumor size (≥ 5 cm, hazard ratio, 4.1; p = 0.003), and CEUS LI-RADS category (LR-M and LR-TIV, hazard ratio, 4.7; p = 0.011) showed independent association with shorter DFS.</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-020-07656-1</identifier><identifier>PMID: 33492470</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Cholangiocarcinoma ; Contrast Media ; Diagnostic Radiology ; Health hazards ; Hepatocellular carcinoma ; Histopathology ; Imaging ; Internal Medicine ; Interventional Radiology ; Lesions ; Liver ; Liver cancer ; Medical imaging ; Medical prognosis ; Medical records ; Medicine ; Medicine & Public Health ; Neuroradiology ; Nodules ; Patients ; Radiology ; Rank tests ; Statistical analysis ; Statistical models ; Survival ; Tumors ; Ultrasonic imaging ; Ultrasound</subject><ispartof>European radiology, 2021-08, Vol.31 (8), p.6397-6405</ispartof><rights>European Society of Radiology 2021. corrected publication 2021</rights><rights>European Society of Radiology 2021. corrected publication 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-e35f2801113fded6d82548dbfd226c9d67576eca11e008ef2200b32e6c05bb613</citedby><cites>FETCH-LOGICAL-c375t-e35f2801113fded6d82548dbfd226c9d67576eca11e008ef2200b32e6c05bb613</cites><orcidid>0000-0002-4057-1997</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-020-07656-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-020-07656-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33492470$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yang, Jie</creatorcontrib><creatorcontrib>Huang, Jia-Yan</creatorcontrib><creatorcontrib>Chen, Xing</creatorcontrib><creatorcontrib>Ling, Wen-Wu</creatorcontrib><creatorcontrib>Luo, Yan</creatorcontrib><creatorcontrib>Shi, Yu-Jun</creatorcontrib><creatorcontrib>Liu, Ji-Bin</creatorcontrib><creatorcontrib>Lu, Qiang</creatorcontrib><creatorcontrib>Lyshchik, Andrej</creatorcontrib><title>Combined hepatocellular-cholangiocarcinoma: can we use contrast-enhanced ultrasound Liver Imaging Reporting and Data System (LI-RADS) to predict the patient’s survival?</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>Objectives
To evaluate the relationship between contrast-enhanced (CE) ultrasound Liver Reporting and Data System (LI-RADS) classification of combined hepatocellular-cholangiocarcinoma (cHCC-CCA) and their histopathological component predominance, and to determine if the CEUS LI-RADS category can be used to predict the patient’s survival after surgical resection.
Methods
Between January 2011 and December 2018, medical records and CEUS of patients with pathologically proven cHCC-CCA were studied. The predominance of hepatocellular carcinoma (HCC)/intrahepatic cholangiocarcinoma (ICC) component of cHCC-CCA was analyzed by histopathology. The proportion of HCC-predominant cHCC-CCA in different LI-RADS category was compared by using Fisher’s exact test. Factors affecting tumor recurrence were analyzed by Cox proportional hazard model. Disease-free survival (DFS) was estimated by using Kaplan-Meier survival curve and compared by log-rank test.
Results
The study included 37 cHCC-CCA patients (33 men, 4 women; average age, 50.4 ± 11.0 years) and 37 nodules (mean diameter, 6.1 ± 3.9 cm). According to CEUS LI-RADS, 62.2% (23/37), 18.9% (7/37), and 18.9% (7/37) of cHCC-CCA were classified as LR-M, LR-5, and LR-TIV, respectively. The ratio of HCC predominance in LR-5 was 100% (10/10) vs 81.5% (22/27) in the LR-M group (
p
= 0.591). In our population, LR-5 patients had longer DFS than LR-M and LR-TIV patients combined (median DFS: 18.0 vs 6.4 months,
p
= 0.016). Multiple lesions (hazard ratio, 3.1;
p
= 0.007), tumor size (≥ 5 cm, hazard ratio, 4.1;
p
= 0.003), and CEUS LI-RADS category (LR-M and LR-TIV, hazard ratio, 4.7;
p
= 0.011) showed independent association with shorter DFS.
Conclusion
cHCC-CCA characterized as LR-5 on CEUS tend to represent HCC-predominant tumors with significantly longer disease-free survival compared to cHCC-CCA categorized as LR-M and LR-TIV.
Key Points
•
By using the American College of Radiology contrast-enhanced ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS), majority (30/37, 81.1%) of cHCC-CCA tumors were classified as LR-M or LR-TIV and only 18.9% (7/30) of cHCC-CCA were categorized as LR-5.
•
Patients with CEUS LR-5 cHCC-CCA had statistically significant longer disease-free time than those with LR-M and TIV cHCC-CCA (median DFS: 18.0 vs 6.4 months, p = 0.016).
•
Multiple lesions (hazard ratio, 3.1; p = 0.007), tumor size (≥ 5 cm, hazard ratio, 4.1; p = 0.003), and CEUS LI-RADS category (LR-M and LR-TIV, hazard ratio, 4.7; p = 0.011) showed independent association with shorter DFS.</description><subject>Cholangiocarcinoma</subject><subject>Contrast Media</subject><subject>Diagnostic Radiology</subject><subject>Health hazards</subject><subject>Hepatocellular carcinoma</subject><subject>Histopathology</subject><subject>Imaging</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Lesions</subject><subject>Liver</subject><subject>Liver cancer</subject><subject>Medical imaging</subject><subject>Medical prognosis</subject><subject>Medical records</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neuroradiology</subject><subject>Nodules</subject><subject>Patients</subject><subject>Radiology</subject><subject>Rank tests</subject><subject>Statistical analysis</subject><subject>Statistical models</subject><subject>Survival</subject><subject>Tumors</subject><subject>Ultrasonic imaging</subject><subject>Ultrasound</subject><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kUtuFDEQhlsIRIbABVggS2zCoqH86BebKJrwGGkkpATWlttdPeOo225s96DsuAZX4FicBDcTQGLBwrJV9dVfv_xn2VMKLylA9SoAcA45sHSqsihzei9bUcFZTqEW97MVNLzOq6YRJ9mjEG4AoKGiepidcC4aJipYZd_XbmyNxY7scVLRaRyGeVA-13s3KLszTiuvjXWjek20suQLkjkg0c5Gr0LM0e6V1Wl-HpaCm21HtuaAnmxGtTN2R65wcj4uL5V6lyoqcn0bIo7kbLvJry4ur1-Q6MjksTM6krhHkpwYtPHH12-BhNkfzEEN54-zB70aAj65u0-zT2_ffFy_z7cf3m3WF9tc86pIhnjRsxoopbzvsCu7mhWi7tq-Y6zUTVdWRVWiVpQiQI09YwAtZ1hqKNq2pPw0OzvqTt59njFEOZqw_Iuy6OYgmaihKgQXZUKf_4PeuNnb5E6mpU3Na8aLRLEjpb0LwWMvJ29G5W8lBbkkKY9JypSk_JWkXFw8u5Oe2xG7PyO_o0sAPwIhtewO_d_d_5H9CbMOq_E</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>Yang, Jie</creator><creator>Huang, Jia-Yan</creator><creator>Chen, Xing</creator><creator>Ling, Wen-Wu</creator><creator>Luo, Yan</creator><creator>Shi, Yu-Jun</creator><creator>Liu, Ji-Bin</creator><creator>Lu, Qiang</creator><creator>Lyshchik, Andrej</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4057-1997</orcidid></search><sort><creationdate>20210801</creationdate><title>Combined hepatocellular-cholangiocarcinoma: can we use contrast-enhanced ultrasound Liver Imaging Reporting and Data System (LI-RADS) to predict the patient’s survival?</title><author>Yang, Jie ; Huang, Jia-Yan ; Chen, Xing ; Ling, Wen-Wu ; Luo, Yan ; Shi, Yu-Jun ; Liu, Ji-Bin ; Lu, Qiang ; Lyshchik, Andrej</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-e35f2801113fded6d82548dbfd226c9d67576eca11e008ef2200b32e6c05bb613</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Cholangiocarcinoma</topic><topic>Contrast Media</topic><topic>Diagnostic Radiology</topic><topic>Health hazards</topic><topic>Hepatocellular carcinoma</topic><topic>Histopathology</topic><topic>Imaging</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Lesions</topic><topic>Liver</topic><topic>Liver cancer</topic><topic>Medical imaging</topic><topic>Medical prognosis</topic><topic>Medical records</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neuroradiology</topic><topic>Nodules</topic><topic>Patients</topic><topic>Radiology</topic><topic>Rank tests</topic><topic>Statistical analysis</topic><topic>Statistical models</topic><topic>Survival</topic><topic>Tumors</topic><topic>Ultrasonic imaging</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yang, Jie</creatorcontrib><creatorcontrib>Huang, Jia-Yan</creatorcontrib><creatorcontrib>Chen, Xing</creatorcontrib><creatorcontrib>Ling, Wen-Wu</creatorcontrib><creatorcontrib>Luo, Yan</creatorcontrib><creatorcontrib>Shi, Yu-Jun</creatorcontrib><creatorcontrib>Liu, Ji-Bin</creatorcontrib><creatorcontrib>Lu, Qiang</creatorcontrib><creatorcontrib>Lyshchik, Andrej</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yang, Jie</au><au>Huang, Jia-Yan</au><au>Chen, Xing</au><au>Ling, Wen-Wu</au><au>Luo, Yan</au><au>Shi, Yu-Jun</au><au>Liu, Ji-Bin</au><au>Lu, Qiang</au><au>Lyshchik, Andrej</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Combined hepatocellular-cholangiocarcinoma: can we use contrast-enhanced ultrasound Liver Imaging Reporting and Data System (LI-RADS) to predict the patient’s survival?</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2021-08-01</date><risdate>2021</risdate><volume>31</volume><issue>8</issue><spage>6397</spage><epage>6405</epage><pages>6397-6405</pages><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>Objectives
To evaluate the relationship between contrast-enhanced (CE) ultrasound Liver Reporting and Data System (LI-RADS) classification of combined hepatocellular-cholangiocarcinoma (cHCC-CCA) and their histopathological component predominance, and to determine if the CEUS LI-RADS category can be used to predict the patient’s survival after surgical resection.
Methods
Between January 2011 and December 2018, medical records and CEUS of patients with pathologically proven cHCC-CCA were studied. The predominance of hepatocellular carcinoma (HCC)/intrahepatic cholangiocarcinoma (ICC) component of cHCC-CCA was analyzed by histopathology. The proportion of HCC-predominant cHCC-CCA in different LI-RADS category was compared by using Fisher’s exact test. Factors affecting tumor recurrence were analyzed by Cox proportional hazard model. Disease-free survival (DFS) was estimated by using Kaplan-Meier survival curve and compared by log-rank test.
Results
The study included 37 cHCC-CCA patients (33 men, 4 women; average age, 50.4 ± 11.0 years) and 37 nodules (mean diameter, 6.1 ± 3.9 cm). According to CEUS LI-RADS, 62.2% (23/37), 18.9% (7/37), and 18.9% (7/37) of cHCC-CCA were classified as LR-M, LR-5, and LR-TIV, respectively. The ratio of HCC predominance in LR-5 was 100% (10/10) vs 81.5% (22/27) in the LR-M group (
p
= 0.591). In our population, LR-5 patients had longer DFS than LR-M and LR-TIV patients combined (median DFS: 18.0 vs 6.4 months,
p
= 0.016). Multiple lesions (hazard ratio, 3.1;
p
= 0.007), tumor size (≥ 5 cm, hazard ratio, 4.1;
p
= 0.003), and CEUS LI-RADS category (LR-M and LR-TIV, hazard ratio, 4.7;
p
= 0.011) showed independent association with shorter DFS.
Conclusion
cHCC-CCA characterized as LR-5 on CEUS tend to represent HCC-predominant tumors with significantly longer disease-free survival compared to cHCC-CCA categorized as LR-M and LR-TIV.
Key Points
•
By using the American College of Radiology contrast-enhanced ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS), majority (30/37, 81.1%) of cHCC-CCA tumors were classified as LR-M or LR-TIV and only 18.9% (7/30) of cHCC-CCA were categorized as LR-5.
•
Patients with CEUS LR-5 cHCC-CCA had statistically significant longer disease-free time than those with LR-M and TIV cHCC-CCA (median DFS: 18.0 vs 6.4 months, p = 0.016).
•
Multiple lesions (hazard ratio, 3.1; p = 0.007), tumor size (≥ 5 cm, hazard ratio, 4.1; p = 0.003), and CEUS LI-RADS category (LR-M and LR-TIV, hazard ratio, 4.7; p = 0.011) showed independent association with shorter DFS.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33492470</pmid><doi>10.1007/s00330-020-07656-1</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-4057-1997</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0938-7994 |
| ispartof | European radiology, 2021-08, Vol.31 (8), p.6397-6405 |
| issn | 0938-7994 1432-1084 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2480754346 |
| source | Springer Nature - Complete Springer Journals |
| subjects | Cholangiocarcinoma Contrast Media Diagnostic Radiology Health hazards Hepatocellular carcinoma Histopathology Imaging Internal Medicine Interventional Radiology Lesions Liver Liver cancer Medical imaging Medical prognosis Medical records Medicine Medicine & Public Health Neuroradiology Nodules Patients Radiology Rank tests Statistical analysis Statistical models Survival Tumors Ultrasonic imaging Ultrasound |
| title | Combined hepatocellular-cholangiocarcinoma: can we use contrast-enhanced ultrasound Liver Imaging Reporting and Data System (LI-RADS) to predict the patient’s survival? |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-23T13%3A09%3A15IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Combined%20hepatocellular-cholangiocarcinoma:%20can%20we%20use%20contrast-enhanced%20ultrasound%20Liver%20Imaging%20Reporting%20and%20Data%20System%20(LI-RADS)%20to%20predict%20the%20patient%E2%80%99s%20survival?&rft.jtitle=European%20radiology&rft.au=Yang,%20Jie&rft.date=2021-08-01&rft.volume=31&rft.issue=8&rft.spage=6397&rft.epage=6405&rft.pages=6397-6405&rft.issn=0938-7994&rft.eissn=1432-1084&rft_id=info:doi/10.1007/s00330-020-07656-1&rft_dat=%3Cproquest_cross%3E2549838235%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2549838235&rft_id=info:pmid/33492470&rfr_iscdi=true |