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多参数磁共振成像改善肝内胆管癌根治性切除术后患者的预后结局。

Multiparametric Magnetic Resonance Imaging Improves the Prognostic Outcomes in Patients With Intrahepatic Cholangiocarcinoma After Curative-Intent Resection.

作者信息

Li Qian, Wei Yi, Che Feng, Zhang Tong, Yao Shan, Zhao Jian, Zhang YuHui, Tang Hehan, Song Bin

机构信息

Department of Radiology, Sichuan University West China Hospital, Chengdu, China.

Department of Evidence-Based Medicine and Clinical Epidemiology, West China Medical School of Medicine/West China Hospital, Sichuan University, Chengdu, China.

出版信息

Front Oncol. 2022 Mar 9;12:756726. doi: 10.3389/fonc.2022.756726. eCollection 2022.

Abstract

PURPOSE

The prognosis of patients with intrahepatic cholangiocarcinoma remains unclear. Thus, this study aimed at investigating whether additional multiparametric magnetic resonance imaging (mpMRI) would guide additional treatment and improve the prognostic outcomes of intrahepatic cholangiocarcinoma patients.

METHODS AND MATERIALS

This retrospective study included 256 patients undergoing dynamic enhanced computed tomography scan only (CT group) and 31 patients undergoing both mpMRI and computed tomography scans (CT+MR group). Propensity score matching (PSM) was used to minimize the potential selection bias and confounding effects. The overall survival (OS) and recurrence-free survival (RFS) rates were compared between the two groups.

RESULTS

More nodules (n = 6), additional biliary dilation (n = 4), and peritumoral parenchymal arterial phase hyperenhancement (n = 18) were found with the additional mpMRI scan, which led to treatment modification. Cox regression analysis revealed the survival advantage of additional mpMRI imaging based on the OS (HR 0.396, 95% CI 0.239-0.657, < 0.001; PSM HR 0.400, 95% CI 0.218-0.736, = 0.003) and RFS (HR 0.558, 95% CI 0.352-0.882, = 0.013; PSM HR 0.508, 95% CI 0.288-0.897, = 0.020).

CONCLUSIONS

Additional mpMRI helps clinicians to select better treatment options, lower the risk of tumor recurrence, and improve the overall survival.

摘要

目的

肝内胆管癌患者的预后仍不明确。因此,本研究旨在调查额外的多参数磁共振成像(mpMRI)是否能指导进一步治疗并改善肝内胆管癌患者的预后结果。

方法和材料

本回顾性研究纳入了仅接受动态增强计算机断层扫描的256例患者(CT组)和同时接受mpMRI及计算机断层扫描的31例患者(CT+MR组)。采用倾向评分匹配(PSM)以尽量减少潜在的选择偏倚和混杂效应。比较两组的总生存期(OS)和无复发生存期(RFS)率。

结果

额外的mpMRI扫描发现了更多结节(n = 6)、额外的胆管扩张(n = 4)和瘤周实质动脉期强化(n = 18),这导致了治疗方案的改变。Cox回归分析显示,基于OS(HR 0.396,95%CI 0.239 - 0.657,<0.001;PSM HR 0.400,95%CI 0.218 - 0.736,= 0.003)和RFS(HR 0.558,95%CI 0.352 - 0.882,= 0.013;PSM HR 0.508,95%CI 0.288 - 0.897,= 0.020),额外的mpMRI成像具有生存优势。

结论

额外的mpMRI有助于临床医生选择更好的治疗方案,降低肿瘤复发风险,并改善总生存期。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5aa3/8959855/487be3a2b770/fonc-12-756726-g001.jpg

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