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- Title
Comparing Survival Outcomes of Patients With LI‐RADS‐M Hepatocellular Carcinomas and Intrahepatic Cholangiocarcinomas.
- Authors
Kierans, Andrea S.; Lafata, Kyle J.; Ludwig, Daniel R.; Burke, Lauren M. B.; Chernyak, Victoria; Fowler, Kathryn J.; Fraum, Tyler J.; McGinty, Katrina A.; McInnes, Matthew D. F.; Mendiratta‐Lala, Mishal; Cunha, Guilherme Moura; Allen, Brian C.; Hecht, Elizabeth M.; Jaffe, Tracy A.; Kalisz, Kevin R.; Ranathunga, Damithri S.; Wildman‐Tobriner, Benjamin; Cardona, Diana M.; Aslam, Anum; Gaur, Sonia
- Abstract
Background: There is a sparsity of data evaluating outcomes of patients with Liver Imaging Reporting and Data System (LI‐RADS) (LR)‐M lesions. Purpose: To compare overall survival (OS) and progression free survival (PFS) between hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (iCCA) meeting LR‐M criteria and to evaluate factors associated with prognosis. Study Type: Retrospective. Subjects: Patients at risk for HCC with at least one LR‐M lesion with histologic diagnosis, from 8 academic centers, yielding 120 patients with 120 LR‐M lesions (84 men [mean age 62 years] and 36 women [mean age 66 years]). Field Strength/Sequence: A 1.5 and 3.0 T/3D T1‐weighted gradient echo, T2‐weighted fast spin‐echo. Assessment: The imaging categorization of each lesion as LR‐M was made clinically by a single radiologist at each site and patient outcome measures were collected. Statistical Tests: OS, PFS, and potential independent predictors were evaluated by Kaplan–Meier method, log‐rank test, and Cox proportional hazard model. A P value of <0.05 was considered significant. Results: A total of 120 patients with 120 LR‐M lesions were included; on histology 65 were HCC and 55 were iCCA. There was similar median OS for patients with LR‐M HCC compared to patients with iCCA (738 days vs. 769 days, P = 0.576). There were no significant differences between patients with HCC and iCCA in terms of sex (47:18 vs. 37:18, P = 0.549), age (63.0 ± 8.4 vs. 63.4 ± 7.8, P = 0.847), etiology of liver disease (P = 0.202), presence of cirrhosis (100% vs. 100%, P = 1.000), tumor size (4.73 ± 3.28 vs. 4.75 ± 2.58, P = 0.980), method of lesion histologic diagnosis (P = 0.646), and proportion of patients who underwent locoregional therapy (60.0% vs. 38.2%, P = 0.100) or surgery (134.8 ± 165.5 vs. 142.5 ± 205.6, P = 0.913). Using multivariable analysis, nonsurgical compared to surgical management (HR, 4.58), larger tumor size (HR, 1.19), and higher MELD score (HR, 1.12) were independently associated with worse OS. Data Conclusion: There was similar OS in patients with LR‐M HCC and LR‐M iCCA, suggesting that LR‐M imaging features may more closely reflect patient outcomes than histology. Evidence Level: 3 Technical Efficacy: Stage 5
- Subjects
SURVIVAL rate; OVERALL survival; HEPATOCELLULAR carcinoma; PROGRESSION-free survival; PROPORTIONAL hazards models; LIVER surgery
- Publication
Journal of Magnetic Resonance Imaging, 2023, Vol 57, Issue 1, p308
- ISSN
1053-1807
- Publication type
Article
- DOI
10.1002/jmri.28218