Open Access

Association between contrast enhancement on contrast‑enhanced CT and lenvatinib effectiveness in hepatocellular carcinoma

  • Authors:
    • Shusuke Okamura
    • Shigeo Shimose
    • Takashi Niizeki
    • Naoki Kamachi
    • Yu Noda
    • Tomotake Shirono
    • Hideki Iwamoto
    • Masahito Nakano
    • Ryoko Kuromatsu
    • Hironori Koga
    • Takuji Torimura
  • View Affiliations

  • Published online on: November 14, 2021     https://doi.org/10.3892/mco.2021.2442
  • Article Number: 8
  • Copyright: © Okamura et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The aim of the present study was to investigate whether the degree of contrast enhancement on contrast‑enhanced (CE)‑CT can predict the prognosis of patients with hepatocellular carcinoma (HCC) treated with lenvatinib (LEN). A total of 67 consecutive patients with LEN‑treated HCC were retrospectively analysed. In the pretreatment CE‑CT, the CT values were measured using a region of interest within the main nodule and the liver parenchyma in the arterial phase, and the macroscopic degree of contrast enhancement of the tumour area was quantified by calculating the enhancement ratio (ER) of the liver parenchyma. The associations of pretreatment ER with progression‑free survival (PFS) and overall survival (OS) were then investigated. There were 20, 27 and 20 patients in the ER ≥1.5, 1.0≤ ER <1.5 and ER <1.0 groups, respectively. There was no significant difference in the PFS and OS among the three ER groups (PFS, P=0.63; OS, P=0.455). The ER <1.0 group had significantly more patients with larger tumour diameters, Barcelona Clinic Liver Cancer (BCLC) stage C with extrahepatic metastases, and higher des‑γ‑carboxy prothrombin values compared with the ER ≥1.0 group, suggesting that ER <1.0 reflected more aggressive types of HCC. The multivariate analysis revealed tumour size and α‑fetoprotein as independent predictors of shorter PFS. Albumin‑bilirubin grade 2 and BCLC stage C were significant predictors of poor OS, whereas the ER was confirmed as a non‑significant predictor of both PFS and OS. Only non‑alternating LEN and transarterial therapy (AT) were identified as independent predictors of unfavourable OS in patients with BCLC stage B HCC. Therefore, LEN has a strong therapeutic effect on HCC, regardless of the degree of contrast enhancement. Furthermore, AT may prolong the OS of LEN‑treated patients with BCLC stage B HCC, regardless of tumour vascularity.
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January-2022
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Spandidos Publications style
Okamura S, Shimose S, Niizeki T, Kamachi N, Noda Y, Shirono T, Iwamoto H, Nakano M, Kuromatsu R, Koga H, Koga H, et al: Association between contrast enhancement on contrast‑enhanced CT and lenvatinib effectiveness in hepatocellular carcinoma. Mol Clin Oncol 16: 8, 2022
APA
Okamura, S., Shimose, S., Niizeki, T., Kamachi, N., Noda, Y., Shirono, T. ... Torimura, T. (2022). Association between contrast enhancement on contrast‑enhanced CT and lenvatinib effectiveness in hepatocellular carcinoma. Molecular and Clinical Oncology, 16, 8. https://doi.org/10.3892/mco.2021.2442
MLA
Okamura, S., Shimose, S., Niizeki, T., Kamachi, N., Noda, Y., Shirono, T., Iwamoto, H., Nakano, M., Kuromatsu, R., Koga, H., Torimura, T."Association between contrast enhancement on contrast‑enhanced CT and lenvatinib effectiveness in hepatocellular carcinoma". Molecular and Clinical Oncology 16.1 (2022): 8.
Chicago
Okamura, S., Shimose, S., Niizeki, T., Kamachi, N., Noda, Y., Shirono, T., Iwamoto, H., Nakano, M., Kuromatsu, R., Koga, H., Torimura, T."Association between contrast enhancement on contrast‑enhanced CT and lenvatinib effectiveness in hepatocellular carcinoma". Molecular and Clinical Oncology 16, no. 1 (2022): 8. https://doi.org/10.3892/mco.2021.2442