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An Optimal Ablative Margin of Small Single Hepatocellular Carcinoma Treated with Image-Guided Percutaneous Thermal Ablation and Local Recurrence Prediction Base on the Ablative Margin: A Multicenter Study

OBJECTIVE: To explore the best ablative margin (AM) for single hepatocellular carcinoma (HCC) patients with image-guided percutaneous thermal ablation (IPTA) based on MRI–MRI fusion imaging, and to develop and validate a local tumor progression (LTP) predictive model based on the recommended AM. MET...

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Autores principales: Li, Feng-Yao, Li, Jian-Guo, Wu, Song-Song, Ye, Huo-Lin, He, Xu-Qi, Zeng, Qing-Jing, Zheng, Rong-Qin, An, Chao, Li, Kai
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8604653/
https://www.ncbi.nlm.nih.gov/pubmed/34815974
http://dx.doi.org/10.2147/JHC.S330746
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author Li, Feng-Yao
Li, Jian-Guo
Wu, Song-Song
Ye, Huo-Lin
He, Xu-Qi
Zeng, Qing-Jing
Zheng, Rong-Qin
An, Chao
Li, Kai
author_facet Li, Feng-Yao
Li, Jian-Guo
Wu, Song-Song
Ye, Huo-Lin
He, Xu-Qi
Zeng, Qing-Jing
Zheng, Rong-Qin
An, Chao
Li, Kai
author_sort Li, Feng-Yao
collection PubMed
description OBJECTIVE: To explore the best ablative margin (AM) for single hepatocellular carcinoma (HCC) patients with image-guided percutaneous thermal ablation (IPTA) based on MRI–MRI fusion imaging, and to develop and validate a local tumor progression (LTP) predictive model based on the recommended AM. METHODS: Between March 2014 and August 2019, 444 treatment-naïve patients with single HCC (diameter ≤3 cm) who underwent IPTA as first-line treatment from three hospitals were included, which were randomly divided into training (n= 296) and validation (n = 148) cohorts. We measured the ablative margin (AM) by MRI–MRI fusion imaging based on pre-ablation and post-ablation images. Then, we followed up their LPT and verified the optimal AM. Risk factors related to LTP were explored through Cox regression models, the nomogram was developed to predict the LTP risk base on the risk factors, and subsequently validated. The predictive performance and discrimination were assessed and compared with conventional indices. RESULTS: The median follow-up was 19.9 months (95% CI 18.0–21.8) for the entire cohort. The results revealed that the tumor size (HR: 2.16; 95% CI 1.25–3.72; P = 0.003) and AM (HR: 0.72; 95% CI, 0.61–0.85; P < 0.001) were independent prognostic factors for LTP. The AM had a pronounced nonlinear impact on LTP, and a cut-off value of 5-mm was optimal. We developed and validated an LTP predictive model based on the linear tumor size and nonlinear AM. The model showed good predictive accuracy and discrimination (training set, concordance index [C-index] of 0.751; validation set, C-index of 0.756) and outperformed other conventional indices. CONCLUSION: The 5-mm AM is recommended for the best IPTA candidates with single HCC (diameter ≤3 cm). We provided an LTP predictive model that exhibited adequate performance for individualized prediction and risk stratification.
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spelling pubmed-86046532021-11-22 An Optimal Ablative Margin of Small Single Hepatocellular Carcinoma Treated with Image-Guided Percutaneous Thermal Ablation and Local Recurrence Prediction Base on the Ablative Margin: A Multicenter Study Li, Feng-Yao Li, Jian-Guo Wu, Song-Song Ye, Huo-Lin He, Xu-Qi Zeng, Qing-Jing Zheng, Rong-Qin An, Chao Li, Kai J Hepatocell Carcinoma Original Research OBJECTIVE: To explore the best ablative margin (AM) for single hepatocellular carcinoma (HCC) patients with image-guided percutaneous thermal ablation (IPTA) based on MRI–MRI fusion imaging, and to develop and validate a local tumor progression (LTP) predictive model based on the recommended AM. METHODS: Between March 2014 and August 2019, 444 treatment-naïve patients with single HCC (diameter ≤3 cm) who underwent IPTA as first-line treatment from three hospitals were included, which were randomly divided into training (n= 296) and validation (n = 148) cohorts. We measured the ablative margin (AM) by MRI–MRI fusion imaging based on pre-ablation and post-ablation images. Then, we followed up their LPT and verified the optimal AM. Risk factors related to LTP were explored through Cox regression models, the nomogram was developed to predict the LTP risk base on the risk factors, and subsequently validated. The predictive performance and discrimination were assessed and compared with conventional indices. RESULTS: The median follow-up was 19.9 months (95% CI 18.0–21.8) for the entire cohort. The results revealed that the tumor size (HR: 2.16; 95% CI 1.25–3.72; P = 0.003) and AM (HR: 0.72; 95% CI, 0.61–0.85; P < 0.001) were independent prognostic factors for LTP. The AM had a pronounced nonlinear impact on LTP, and a cut-off value of 5-mm was optimal. We developed and validated an LTP predictive model based on the linear tumor size and nonlinear AM. The model showed good predictive accuracy and discrimination (training set, concordance index [C-index] of 0.751; validation set, C-index of 0.756) and outperformed other conventional indices. CONCLUSION: The 5-mm AM is recommended for the best IPTA candidates with single HCC (diameter ≤3 cm). We provided an LTP predictive model that exhibited adequate performance for individualized prediction and risk stratification. Dove 2021-11-15 /pmc/articles/PMC8604653/ /pubmed/34815974 http://dx.doi.org/10.2147/JHC.S330746 Text en © 2021 Li et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Li, Feng-Yao
Li, Jian-Guo
Wu, Song-Song
Ye, Huo-Lin
He, Xu-Qi
Zeng, Qing-Jing
Zheng, Rong-Qin
An, Chao
Li, Kai
An Optimal Ablative Margin of Small Single Hepatocellular Carcinoma Treated with Image-Guided Percutaneous Thermal Ablation and Local Recurrence Prediction Base on the Ablative Margin: A Multicenter Study
title An Optimal Ablative Margin of Small Single Hepatocellular Carcinoma Treated with Image-Guided Percutaneous Thermal Ablation and Local Recurrence Prediction Base on the Ablative Margin: A Multicenter Study
title_full An Optimal Ablative Margin of Small Single Hepatocellular Carcinoma Treated with Image-Guided Percutaneous Thermal Ablation and Local Recurrence Prediction Base on the Ablative Margin: A Multicenter Study
title_fullStr An Optimal Ablative Margin of Small Single Hepatocellular Carcinoma Treated with Image-Guided Percutaneous Thermal Ablation and Local Recurrence Prediction Base on the Ablative Margin: A Multicenter Study
title_full_unstemmed An Optimal Ablative Margin of Small Single Hepatocellular Carcinoma Treated with Image-Guided Percutaneous Thermal Ablation and Local Recurrence Prediction Base on the Ablative Margin: A Multicenter Study
title_short An Optimal Ablative Margin of Small Single Hepatocellular Carcinoma Treated with Image-Guided Percutaneous Thermal Ablation and Local Recurrence Prediction Base on the Ablative Margin: A Multicenter Study
title_sort optimal ablative margin of small single hepatocellular carcinoma treated with image-guided percutaneous thermal ablation and local recurrence prediction base on the ablative margin: a multicenter study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8604653/
https://www.ncbi.nlm.nih.gov/pubmed/34815974
http://dx.doi.org/10.2147/JHC.S330746
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