Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro Gangnam-gu, Seoul, 06351, Republic of Korea.
Department of Health Sciences and Technology, Samsung Advanced Institute of Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, 06351, Republic of Korea.
Eur Radiol. 2021 Sep;31(9):6555-6567. doi: 10.1007/s00330-021-07769-1. Epub 2021 Mar 13.
To evaluate early (≤ 2 years) local tumor progression (LTP), intrahepatic distant metastasis (IDR), and extrahepatic metastasis (EM) of primary hepatic malignant tumors with arterial rim enhancement (RE) after RFA in comparison with non-RE tumors.
Three hundred forty-nine patients who underwent RFA for primary hepatic malignant tumors between January 2009 and December 2016 were included. The patients' tumors were classified into non-RE, RE only (RO), and RE plus other targetoid appearances (REoT). Cumulative LTP, IDR, and EM rates at 1 and 2 years after RFA were calculated using the Kaplan-Meier method and compared using the log-rank test. Prognostic factors for the outcomes were assessed using a Cox proportional hazards model.
There were 303 non-RE, 19 RO, and 27 REoT tumors. The REoT tumors had a significantly higher rate of IDR and EM than non-RE (p = 0.04 for IDR; and p < 0.01 for EM, respectively) at 1 year after RFA. At 2 years, LTP and EM rates were significantly higher for REoT than for non-RE (p = 0.001 for LTP; and p = 0.444 for EM, respectively). The RO tumors did not have different outcomes than non-RE at 1 and 2 years after RFA. Multivariable analysis verified that REoT was a significant factor for IDR (p = 0.04) and EM (p = 0.01) at 1 year and LTP (p = 0.02) at 2 years.
Tumors with REoT had poor LTP, IDR, and EM within 2 years after RFA than non-RE tumors. However, tumors with RO showed similar results as non-RE tumors.
• Tumors with Rim enhancement plus other targetoid appearances (REoT) had a significantly higher rate of recurrence than non-rim enhancing (RE) tumors at 1 and 2 years after RFA. • Tumors with rim enhancement only did not have different outcomes than non-RE at 1 and 2 years after RFA.
评估原发性肝恶性肿瘤经射频消融（RFA）治疗后，动脉边缘增强（RE）与非 RE 肿瘤相比，早期（≤2 年）局部肿瘤进展（LTP）、肝内远处转移（IDR）和肝外转移（EM）的情况。
本研究纳入了 2009 年 1 月至 2016 年 12 月期间因原发性肝恶性肿瘤接受 RFA 治疗的 349 名患者。根据肿瘤是否存在 RE 或仅存在边缘增强（RO）或边缘增强加其他靶样外观（REoT），将患者的肿瘤分为非 RE、RE 仅（RO）和 REoT。采用 Kaplan-Meier 法计算 RFA 后 1 年和 2 年时的累积 LTP、IDR 和 EM 发生率，并采用对数秩检验进行比较。采用 Cox 比例风险模型评估预后因素。
共有 303 个非 RE、19 个 RO 和 27 个 REoT 肿瘤。与非 RE 相比，REoT 肿瘤在 RFA 后 1 年时 IDR 和 EM 的发生率显著更高（p = 0.04 用于 IDR；p < 0.01 用于 EM）。在 2 年时，REoT 的 LTP 和 EM 发生率显著高于非 RE（p = 0.001 用于 LTP；p = 0.444 用于 EM）。RO 肿瘤在 RFA 后 1 年和 2 年时与非 RE 相比无不同结局。多变量分析证实，REoT 是 1 年时 IDR（p = 0.04）和 EM（p = 0.01）以及 2 年时 LTP（p = 0.02）的显著预后因素。
与非 RE 肿瘤相比，REoT 肿瘤在 RFA 后 2 年内 LTP、IDR 和 EM 的发生率更高。然而，RO 肿瘤与非 RE 肿瘤的结果相似。
边缘增强加其他靶样外观（REoT）肿瘤在 RFA 后 1 年和 2 年时的复发率明显高于非边缘增强（RE）肿瘤。
边缘增强仅肿瘤在 RFA 后 1 年和 2 年时与非 RE 肿瘤无不同结局。
