Imaging characteristics of hepatocellular carcinoma associated with transarterial chemoembolization refractoriness

Abstract

Objectives: Comparison and evaluation of imaging characteristics of hepatocellular carcinoma related to refractoriness of transarterial chemoembolization (TACE).
Methods: A descriptive cross-sectional, retrospective study was conducted on 71 patients diagnosed with hepatocellular carcinoma and treated with at least two initial chemoembolization procedures from January 2022 to January 2024 at the Radiology Center of Bach Mai Hospital. The patients were divided into two groups: TACE refractoriness and non-TACE refractoriness. A comparison and evaluation of demographic, laboratory, and imaging characteristics between the two groups were conducted to identify risk factors for TACE refractoriness.
Results: Out of 71 patients, 31 exhibited TACE refractoriness. Characteristics such as age, gender, risk factors for cirrhosis, and cirrhosis status according to the Child-Pugh classification were not associated with TACE refractoriness. Logistic regression showed that bilobar tumor distribution (OR=4.049, 95% CI [1.323; 9.267], p = 0.0018), >1 tumor (OR=4.052, 95% CI [1.052; 5.266], p = 0.043), and beyond the up-to-7 criteria (OR=3.555, 95% CI [1.201; 7.284], p = 0.026) were associated with TACE refractoriness, with a model predictive accuracy of 74.6%.
Conclusion: Imaging characteristics such as bilobar tumor distribution, more than 1 tumors, and beyond up-to-7 criteria are
independent risk factors that increase the likelihood of TACE refractoriness