Tumor angiogenesis-related parameters in multi-phase enhanced CT correlated with outcomes of hepatocellular carcinoma patients after radical hepatectomy

Purpose: To determine if the prognosis of hepatocellular carcinoma (HCC) patients after radical hepatectomy may be indicated by the degree and pattern of contrast enhancement on preoperative computed tomography (CT) scan of the tumor. Materials: The degree and patterns of enhancement of HCC tumor images were retrospectively reviewed of 87 HCC patients who underwent preoperative contrast-enhanced CT prior to radical hepatectomy. The patients' conditions and outcomes were followed after surgery. The Kaplan-Meier method and log-rank test were used for univariate survival analysis. The Cox proportional hazard method was performed for multivariate analysis. Results: The 1- and 3-year cumulative survival rates of this cohort were 78% and 57%, respectively. The univariate analyses showed that risk factors contributing to survival were, in the arterial phase, the degree of tumor enhancement (A-dTE), tumor-to-aortic ratio (A-T/A), and tumor-to-liver CT value ratio (A-T/L); and in the portal venous phase, the tumor-to-aortic ratio (P-T/A), and tumor-to-liver ratio (P-T/L). Further multivariable Cox analysis revealed that the A-T/A (P = 0.020) and P-T/L (P = 0.045) were, independently, significant factors related to the survival rate. A-T/A <0.25, P-T/L <0.85, or both predicted a poor outcome for HCC patients after radical hepatectomy. Conclusions: Preoperative multi-phase contrast-enhanced CT parameters could be helpful in the prognosis of HCC patents after radical hepatectomy. (C) 2016 Elsevier Ltd. All rights reserved.