Korean Journal of Radiology

  • 제16권5호
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  • Pages.1068-1078
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  • 2015
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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Does Establishing a Safety Margin Reduce Local Recurrence in Subsegmental Transarterial Chemoembolization for Small Nodular Hepatocellular Carcinomas?

  • Kang, Hyo-Jin (Department of Radiology, Seoul National University Hospital) ;
  • Kim, Young Il (Department of Radiology, Seoul National University Hospital) ;
  • Kim, Hyo-Cheol (Department of Radiology, Seoul National University Hospital) ;
  • Jae, Hwan Jun (Department of Radiology, Seoul National University Hospital) ;
  • Hur, Saebeom (Department of Radiology, Seoul National University Hospital) ;
  • Chung, Jin Wook (Department of Radiology, Seoul National University Hospital)
  • 투고 : 2014.11.28
  • 심사 : 2015.05.21
  • 발행 : 2015.09.01
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: To test the hypothesis that a safety margin may affect local tumor recurrence (LTR) in subsegmental chemoembolization. Materials and Methods: In 101 patients with 128 hepatocellular carcinoma (HCC) nodules (1-3 cm in size and ${\leq}3$ in number), cone-beam CT-assisted subsegmental lipiodol chemoembolization was performed. Immediately thereafter, a non-contrast thin-section CT image was obtained to evaluate the presence or absence of intra-tumoral lipiodol uptake defect and safety margin. The effect of lipiodol uptake defect and safety margin on LTR was evaluated. Univariate and multivariate analyses were performed to indentify determinant factors of LTR. Results: Of the 128 HCC nodules in 101 patients, 49 (38.3%) nodules in 40 patients showed LTR during follow-up period (median, 34.1 months). Cumulative 1- and 2-year LTR rates of nodules with lipiodol uptake defect (n = 27) and those without defect (n = 101) were 58.1% vs. 10.1% and 72.1% vs. 19.5%, respectively (p < 0.001). Among the 101 nodules without a defect, the 1- and 2-year cumulative LTR rates for nodules with complete safety margin (n = 52) and those with incomplete safety margin (n = 49) were 9.8% vs. 12.8% and 18.9% vs. 19.0% (p = 0.912). In multivariate analyses, ascites (p = 0.035), indistinct tumor margin on cone-beam CT (p = 0.039), heterogeneous lipiodol uptake (p = 0.023), and intra-tumoral lipiodol uptake defect (p < 0.001) were determinant factors of higher LTR. Conclusion: In lipiodol chemoembolization, the safety margin in completely lipiodolized nodule without defect will not affect LTR in small nodular HCCs.

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참고문헌

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