Comparing Survival Outcomes of Patients With LI‐RADS‐M Hepatocellular Carcinomas and Intrahepatic Cholangiocarcinomas
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)...
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| Published in | Journal of magnetic resonance imaging Vol. 57; no. 1; pp. 308 - 317 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Hoboken, USA
John Wiley & Sons, Inc
01.01.2023
Wiley Subscription Services, Inc |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1053-1807 1522-2586 1522-2586 |
| DOI | 10.1002/jmri.28218 |
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| 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 |
|---|---|
| AbstractList | There is a sparsity of data evaluating outcomes of patients with Liver Imaging Reporting and Data System (LI-RADS) (LR)-M lesions.
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.
Retrospective.
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]).
A 1.5 and 3.0 T/3D T
-weighted gradient echo, T
-weighted fast spin-echo.
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.
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.
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.
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.
3 TECHNICAL EFFICACY: Stage 5. There is a sparsity of data evaluating outcomes of patients with Liver Imaging Reporting and Data System (LI-RADS) (LR)-M lesions.BACKGROUNDThere is a sparsity of data evaluating outcomes of patients with Liver Imaging Reporting and Data System (LI-RADS) (LR)-M lesions.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.PURPOSETo 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.Retrospective.STUDY TYPERetrospective.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]).SUBJECTSPatients 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]).A 1.5 and 3.0 T/3D T1 -weighted gradient echo, T2 -weighted fast spin-echo.FIELD STRENGTH/SEQUENCEA 1.5 and 3.0 T/3D T1 -weighted gradient echo, T2 -weighted fast spin-echo.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.ASSESSMENTThe imaging categorization of each lesion as LR-M was made clinically by a single radiologist at each site and patient outcome measures were collected.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.STATISTICAL TESTSOS, 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.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.RESULTSA 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.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.DATA CONCLUSIONThere 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.3 TECHNICAL EFFICACY: Stage 5.EVIDENCE LEVEL3 TECHNICAL EFFICACY: Stage 5. BackgroundThere is a sparsity of data evaluating outcomes of patients with Liver Imaging Reporting and Data System (LI‐RADS) (LR)‐M lesions.PurposeTo 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 TypeRetrospective.SubjectsPatients 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/SequenceA 1.5 and 3.0 T/3D T1‐weighted gradient echo, T2‐weighted fast spin‐echo.AssessmentThe 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 TestsOS, 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.ResultsA 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 ConclusionThere 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 Level3Technical EfficacyStage 5 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 |
| Author | Chernyak, Victoria Kalisz, Kevin R. Bashir, Mustafa R. Aslam, Anum McGinty, Katrina A. Jaffe, Tracy A. Allen, Brian C. Wildman‐Tobriner, Benjamin Fowler, Kathryn J. Lafata, Kyle J. McInnes, Matthew D. F. Cardona, Diana M. Burke, Lauren M. B. Kierans, Andrea S. Hecht, Elizabeth M. Cunha, Guilherme Moura Ludwig, Daniel R. Ranathunga, Damithri S. Fraum, Tyler J. Mendiratta‐Lala, Mishal Gaur, Sonia |
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| Snippet | 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... There is a sparsity of data evaluating outcomes of patients with Liver Imaging Reporting and Data System (LI-RADS) (LR)-M lesions. To compare overall survival... BackgroundThere is a sparsity of data evaluating outcomes of patients with Liver Imaging Reporting and Data System (LI‐RADS) (LR)‐M lesions.PurposeTo compare... There is a sparsity of data evaluating outcomes of patients with Liver Imaging Reporting and Data System (LI-RADS) (LR)-M lesions.BACKGROUNDThere is a sparsity... |
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| SubjectTerms | Age Aged Bile Duct Neoplasms - diagnostic imaging Bile Ducts, Intrahepatic Carcinoma, Hepatocellular - pathology Cholangiocarcinoma Cholangiocarcinoma - diagnostic imaging Cirrhosis Contrast Media Diagnosis Etiology Evaluation Female Field strength HCC Hepatocellular carcinoma Histology Humans Lesions Liver Liver cancer Liver cirrhosis Liver diseases Liver Neoplasms - surgery LI‐RADS M Magnetic resonance imaging Magnetic Resonance Imaging - methods Male Mean Medical imaging Medical prognosis Middle Aged MRI overall survival Patients progression free survival Rank tests Retrospective Studies Statistical analysis Statistical models Statistical tests Survival Tumors |
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| Title | Comparing Survival Outcomes of Patients With LI‐RADS‐M Hepatocellular Carcinomas and Intrahepatic Cholangiocarcinomas |
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