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Imaging-based prediction of early recurrence and neoadjuvant therapy outcomes for resectable beyond Milan HCC

  • 0Department of Radiology, West China Hospital Sichuan University Chengdu Sichuan China.
European Journal of Radiology +

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January 28, 2025

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January 28, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

An MRI-based Early Recurrence Outside Milan (EROM) score predicts early recurrence-free survival in hepatocellular carcinoma (HCC) patients after surgery. The EROM score also helps assess tumor progression risks in patients receiving neoadjuvant therapy.

Area Of Science

  • Hepatobiliary imaging
  • Oncologic imaging
  • Radiomics

Background

  • Hepatocellular carcinoma (HCC) beyond the Milan criteria presents challenges for surgical resection.
  • Predicting early recurrence after treatment is crucial for patient management.
  • Current staging systems may not fully capture individual recurrence risk.

Purpose Of The Study

  • Develop and validate an MRI-based model to predict early recurrence-free survival (RFS) after surgical resection for beyond Milan HCC.
  • Assess the model's performance in patients receiving neoadjuvant therapy.
  • Compare the model's predictive accuracy against the BCLC staging system.

Main Methods

  • Retrospective study of 279 patients with resectable BCLC A/B beyond Milan HCC.
  • Development of an MRI-based Early Recurrence Outside Milan (EROM) score using Cox regression.
  • Validation of the EROM score in patients undergoing upfront surgical resection and neoadjuvant therapy.

Main Results

  • The EROM score, incorporating alpha-fetoprotein, tumor size, infiltrative appearance, and arterial phase hyperenhancement, outperformed the BCLC system (C-index 0.69 vs. 0.52).
  • High-risk EROM score patients showed significantly higher tumor progression rates (25.0% vs. 0.0%) after neoadjuvant therapy.
  • High-risk EROM score patients had lower 2-year RFS (16.0% vs. 39.3%) postoperatively.

Conclusions

  • The MRI-based EROM score provides a noninvasive method for predicting early RFS in patients with resectable beyond Milan HCC.
  • The EROM score effectively identifies patients at higher risk of tumor progression following neoadjuvant therapy.
  • This model can aid in personalized treatment strategies for advanced HCC.

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