Details der Publikation - Enhanced patterns on intraoperative contrast-enhanced ultrasonography predict outcomes after curative liver resection in patients with hepatocellular carcinoma

Enhanced patterns on intraoperative contrast-enhanced ultrasonography predict outcomes after curative liver resection in patients with hepatocellular carcinoma

Purpose This study aimed to clarify what hepatocellular carcinoma (HCC) phenotype, as categorized by intraoperative contrast-enhanced ultrasonography (CEUS), showed a high risk of recurrence after hepatic resection. Methods Patients who underwent initial curative hepatectomy with intraoperative CEUS for a single HCC nodule were retrospectively assigned to three patterns of fine (FI), vascular (VA), and irregular (IR) according to the maximum intensity projection pattern based on intraoperative CEUS. Staining was performed for Ki-67, pyruvate kinase type M2 (PKM2), and vascular endothelial growth factor (VEGF) to assess the tumor proliferative activity, tumor glucose metabolism, and angiogenesis, respectively. Results Of 116 patients, 18, 50, and 48 were assigned to the FI, VA and IR patterns, respectively. IR patients demonstrated a significantly worse prognosis for both the recurrence-free survival (RFS) and overall survival (OS) (P = 0.0002, 0.0262, respectively) than did patients with other patterns. A multivariate analysis revealed an IR pattern in intraoperative CEUS to be an independent predictive factor for a poor RFS, and major hepatectomy and an IR pattern were independent predictive factors for a poor OS. An IR pattern was closely related to the tumor size (≥ 3.3 cm) and poor histological differentiation and showed a high Ki-67 index, low VEGF expression, and high PKM2 expression. Conclusion IR-pattern HCCs as classified by intraoperative CEUS may be associated with a higher risk of recurrence and worse outcomes in HCC patients after hepatic resection than other patterns..

Medienart:	E-Artikel

Erscheinungsjahr:	2020
Erschienen:	2020

Enthalten in:	Zur Gesamtaufnahme - volume:51
Enthalten in:	Surgery today - 51(2020), 5 vom: 22. Sept., Seite 764-776

Sprache:	Englisch

Beteiligte Personen:	Nakamura, Ikuo [VerfasserIn] Hatano, Etsuro [VerfasserIn] Tada, Masaharu [VerfasserIn] Kawabata, Yusuke [VerfasserIn] Tamagawa, Shinjiro [VerfasserIn] Kurimoto, Ami [VerfasserIn] Iwama, Hideaki [VerfasserIn] Toriguchi, Kan [VerfasserIn] Sueoka, Hideaki [VerfasserIn] Iida, Kenjiro [VerfasserIn] Yoshida, Masahiro [VerfasserIn] Nishimura, Takashi [VerfasserIn] Iijima, Hiroko [VerfasserIn]

Links:	Volltext [lizenzpflichtig]

BKL:	44.65$jChirurgie
Themen:	Hepatocellular carcinoma Intraoperative contrast-enhanced ultrasonography Liver resection

RVK:	RVK Klassifikation ELIB24

Anmerkungen:	© Springer Nature Singapore Pte Ltd. 2020

doi:	10.1007/s00595-020-02145-w

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	OLC2124977075

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245	1	0	\|a Enhanced patterns on intraoperative contrast-enhanced ultrasonography predict outcomes after curative liver resection in patients with hepatocellular carcinoma
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520			\|a Purpose This study aimed to clarify what hepatocellular carcinoma (HCC) phenotype, as categorized by intraoperative contrast-enhanced ultrasonography (CEUS), showed a high risk of recurrence after hepatic resection. Methods Patients who underwent initial curative hepatectomy with intraoperative CEUS for a single HCC nodule were retrospectively assigned to three patterns of fine (FI), vascular (VA), and irregular (IR) according to the maximum intensity projection pattern based on intraoperative CEUS. Staining was performed for Ki-67, pyruvate kinase type M2 (PKM2), and vascular endothelial growth factor (VEGF) to assess the tumor proliferative activity, tumor glucose metabolism, and angiogenesis, respectively. Results Of 116 patients, 18, 50, and 48 were assigned to the FI, VA and IR patterns, respectively. IR patients demonstrated a significantly worse prognosis for both the recurrence-free survival (RFS) and overall survival (OS) (P = 0.0002, 0.0262, respectively) than did patients with other patterns. A multivariate analysis revealed an IR pattern in intraoperative CEUS to be an independent predictive factor for a poor RFS, and major hepatectomy and an IR pattern were independent predictive factors for a poor OS. An IR pattern was closely related to the tumor size (≥ 3.3 cm) and poor histological differentiation and showed a high Ki-67 index, low VEGF expression, and high PKM2 expression. Conclusion IR-pattern HCCs as classified by intraoperative CEUS may be associated with a higher risk of recurrence and worse outcomes in HCC patients after hepatic resection than other patterns.
650		4	\|a Hepatocellular carcinoma
650		4	\|a Intraoperative contrast-enhanced ultrasonography
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700	1		\|a Iijima, Hiroko \|4 aut
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Enhanced patterns on intraoperative contrast-enhanced ultrasonography predict outcomes after curative liver resection in patients with hepatocellular carcinoma

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