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18F-fluorodeoxyglucose PET/CT as an independent predictor for patients with hepatocellular carcinoma combined with major portal vein tumor thrombus

Annals of Surgical Treatment and Research 2020년 99권 1호 p.8 ~ 17
 ( Hu Xu-Guang ) - Jiangxi Cancer Center Department of Hepatobiliary Surgery

 ( Shen Xue-Yin ) - Ajou University School of Medicine Department of Surgery
 ( Nan Jin-Niang ) - Jiangxi Health Career College of China Department of Clinical Medicine
김인규 ( Kim In-Gyu ) - Health Insurance Review and Assessment Service
윤준기 ( Yoon Joon-Kee ) - Ajou University School of Medicine Department of Nuclear Medicine and Molecular Imaging
홍성연 ( Hong Sung-Yeon ) - Ajou University School of Medicine Department of Surgery
김미나 ( Kim Mi-Na ) - Ajou University School of Medicine Department of Surgery
김봉완 ( Kim Bong-Wan ) - Ajou University School of Medicine Department of Surgery
왕희정 ( Wang Hee-Jung ) - Ajou University School of Medicine Department of Surgery

Abstract


Purpose: Hepatocellular carcinoma (HCC) patients with major portal vein tumor thrombosis (mPVTT) complications were generally characterized by extremely poor prognoses. The aim of this study was to explore the role of 18F-fluorodeoxyglucose (18F-FDG) PET/CT imaging in predicting HCC complicated by mPVTT.

Methods: Five hundred one HCC patients received surgery in our hospital during November 2008 to December 2014, among which 32 patients (6.4%) were diagnosed as HCC complicated by mPVTT. Six cases were excluded for reasons of complex medical conditions, including 2 cases of salvage liver transplantation, 2 cases of re-resection, 1 case of mPVTT combined with inferior vina cava tumor thrombosis, and 1 case of residual portal vein tumor thrombosis. Ultimately, 26 cases were enrolled in this study. The maximal tumor standardized uptake value (SUVmax) was identified as a predictive factor and detected. The univariate and multivariate regression analyses were performed to identify the prognostic factors for recurrence-free survival (RFS) and overall survival (OS) of HCC patients complicated by mPVTT.

Results: Our results showed that the median OS was 16 months. The 1-, 3-, and 5-year cumulative OS was 55.6%, 31.7%, and 31.7%, respectively. The multivariate regression analysis revealed that SUVmax ≥ 4.65 was the only independent risk factor for RFS and OS.

Conclusion: SUVmax was an independent predictor for RFS and OS of patients suffering from both HCC and mPVTT. L ow SUVmax could serve as an effective factor for selecting candidates with low recurrence risks and for helping with improving patient survival after surgical resection.

키워드

Hepatocellular carcinoma; Portal vein; Positron emission tomography computed tomography; Thrombus
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