Work

Predictive Value of Radiographic Tumor Burden Score in Hepatocellular Carcinoma Within Milan Criteria After Microwave Ablation: Implications for Long‐Term Outcomes and Treatment Planning

Year: 2025

Type: article

Abstract: OBJECTIVE: This study aimed to investigate the predictive value of the radiographic tumor burden score (TBS) for long-term outcomes in hepatocellular carcinoma (HCC) patients meeting Milan criteria after microwave ablation (MWA) and to delineate its significance in guiding treatment planning. METHODS: Retrospective analysis was conducted on clinical data from 198 HCC patients meeting Milan criteria, who underwent MWA at our hospital from January 2011 to December 2018. Using X-tile software, the optimal critical value of TBS was determined, leading to the categorization of patients into high- and low-TBS groups. Propensity score matching (PSM) was applied to balance covariates between these groups. RESULTS: Before PSM, the 5-year overall survival (OS) rate and recurrence-free survival (RFS) rate in the high-TBS (47 cases) and low-TBS groups (151 cases) were 32.8% versus 59.7% (p = 0.033) and 23.4% versus 50.9% (p = 0.016), respectively. Following PSM, the 5-year OS rate and RFS rate in the high-TBS (44 cases) and low-TBS groups (95 cases) were 30.2% versus 64.1% (p = 0.011) and 21.9% versus 45.9% (p = 0.0059), respectively. Cox analysis identified high TBS and percutaneous microwave ablation (PMWA) as independent risk factors for OS and RFS. The stratified analysis revealed that the median RFS time for patients undergoing laparoscopic microwave ablation (LMWA) (20 cases) and PMWA (24 cases) in the high-TBS group (44 cases) was 45 and 10.5 months, respectively (p = 0.006). CONCLUSION: TBS emerged as a robust predictor for the long-term outcomes of HCC within Milan criteria after MWA. A higher TBS was associated with a diminished long-term survival rate. Notably, among HCC patients meeting Milan criteria, those with TBS > 3 exhibited a prolonged median RFS time following LMWA compared to PWMA.

Source: Cancer Medicine

DOI: 10.1002/cam4.70806

Authors: Xiaolin Liu, Jing Wang, Feng Xu, Jing Chen, Mingyuan Zhu, Xiaoguang Wang

Institutions: Jiaxing University, General Hospital of Shenyang Military Region, Sheng Jing Hospital, China Medical University

Language: English

Topic: Hepatocellular Carcinoma Treatment and Prognosis

Subfield: Hepatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $4,700