Tumor Volume Doubling Time as a Dynamic Prognostic Marker for Patients with Hepatocellular Carcinoma
Tumor Volume Doubling Time as a Dynamic Prognostic Marker for Patients with Hepatocellular Carcinoma
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DOI：
10.1007/s10620-017-4708-6
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发表时间：
2017-10-01
影响因子：
3.1
通讯作者：
Kim, Kang Mo
中科院分区：
文献类型：
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作者：
Kim, Jong Kwan;Kim, Hyung-Don;Kim, Kang Mo
为了评估肿瘤生长速度在肝细胞癌（HCC）患者中的临床价值，我们通过计算肿瘤体积倍增时间（TVDT）来研究HCC的生长速度及其对生存和复发的影响。对269例HCC患者进行了回顾性队列研究，这些患者接受了两次或两次以上的计算机断层扫描或磁共振成像预处理成像研究。通过比较影像学检查的肿瘤体积计算肿瘤生长速率和TVDT。评估与TVDT < 2个月独立相关的临床参数。将患者分为慢生长组（159例TVDT≥2个月）和快速生长组（110例TVDT < 2个月），比较两组患者的生存和复发情况。根据TVDT评价经动脉化疗栓塞（TACE）的疗效。中位肿瘤生长率为37.5%/月，TVDT为2.37个月。经logistic回归分析，Child-Pugh评分高、初始肿瘤直径小、总血管侵犯、肿瘤多样性与TVDT < 2个月独立相关（P < 0.05）。快速生长组患者生存率较低，复发率较高（P < 0.05）。快速生长组TACE疗效较差（P < 0.05）。肝细胞癌生长速度快与肝功能差和肿瘤生物学侵袭性有关。较短tvdt的HCC患者表现出较差的生存和复发结果，以及对TACE的不良反应。
To evaluate the clinical value of tumor growth rate in hepatocellular carcinoma (HCC) patients, we investigated the growth rate of HCC by calculating the tumor volume doubling time (TVDT) and its impact on survival and recurrence.A retrospective cohort study of 269 HCC patients who underwent two or more pretreatment imaging studies of computed tomography or magnetic resonance imaging was performed. Tumor growth rate and TVDT were calculated by comparing tumor volumes between imaging studies. Clinical parameters independently related to a TVDT of < 2 months were evaluated. After dividing patients into slow-growing (159 patients with TVDT > 2 months) and rapid-growing (110 patients with TVDT < 2 months) groups, we compared the groups in terms of their survival and recurrence outcomes. The response to transarterial chemoembolization (TACE) was evaluated according to TVDT.The median tumor growth rate and TVDT were 37.5%/month and 2.37 months, respectively. By logistic regression analyses, a high Child-Pugh score, small initial tumor diameter, gross vascular invasion, and tumor multiplicity were found to be independently associated with a TVDT of < 2 months (P < 0.05). Patients in the rapid-growing group had lower survival rates and higher recurrence rates (P < 0.05). The response to TACE was worse in the rapid-growing group (P < 0.05).A fast HCC growth rate is associated with poor liver function and aggressive tumor biology. HCC patients with shorter TVDTs exhibit poorer survival and recurrence outcomes as well as a poor response to TACE.