Corona enhancement combined with microvascular invasion for prognosis prediction of macrotrabecular-massive hepatocellular carcinoma subtype

Lili Yang; Meng Wang; Yanyan Zhu; Jiahui Zhang; Junhan Pan; Yanci Zhao; Ke Sun; Feng Chen

doi:10.3389/fonc.2023.1138848

Corona enhancement combined with microvascular invasion for prognosis prediction of macrotrabecular-massive hepatocellular carcinoma subtype

Front Oncol. 2023 Feb 20:13:1138848. doi: 10.3389/fonc.2023.1138848. eCollection 2023.

Authors

Lili Yang¹, Meng Wang², Yanyan Zhu¹, Jiahui Zhang³, Junhan Pan¹, Yanci Zhao¹, Ke Sun², Feng Chen^{1

4}

Affiliations

¹ Department of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
² Department of Pathology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
³ Department of Radiology, Third People's Hospital of Hangzhou, Hangzhou, Zhejiang, China.
⁴ Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, Zhejiang, China.

Abstract

Objectives: The macrotrabecular-massive (MTM) subtype of hepatocellular carcinoma (HCC) is aggressive and associated with an unfavorable prognosis. This study aimed to characterize MTM-HCC features based on contrast-enhanced MRI and to evaluate the prognosis of imaging characteristics combined with pathology for predicting early recurrence and overall survival after surgery.

Methods: This retrospective study included 123 patients with HCC that underwent preoperative contrast-enhanced MRI and surgery, between July 2020 and October 2021. Multivariable logistic regression was performed to investigate factors associated with MTM-HCC. Predictors of early recurrence were determined with a Cox proportional hazards model and validated in a separate retrospective cohort.

Results: The primary cohort included 53 patients with MTM-HCC (median age 59 years; 46 male and 7 females; median BMI 23.5 kg/m2) and 70 subjects with non-MTM HCC (median age 61.5 years; 55 male and 15 females; median BMI 22.6 kg/m2) (All P>0.05). The multivariate analysis identified corona enhancement (odds ratio [OR]=2.52, 95% CI: 1.02-6.24; P=0.045) as an independent predictor of the MTM-HCC subtype. The multiple Cox regression analysis identified corona enhancement (hazard ratio [HR]=2.56, 95% CI: 1.08-6.08; P=0.033) and MVI (HR=2.45, 95% CI: 1.40-4.30; P=0.002) as independent predictors of early recurrence (area under the curve=0.790, P<0.001). The prognostic significance of these markers was confirmed by comparing results in the validation cohort to those from the primary cohort. Corona enhancement combined with MVI was significantly associated with poor outcomes after surgery.

Conclusions: A nomogram for predicting early recurrence based on corona enhancement and MVI could be used to characterize patients with MTM-HCC and predict their prognosis for early recurrence and overall survival after surgery.

Keywords: Magnetic resonance imaging (MRI); hepatocellular carcinoma; nomogram; prognosis; survival.