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Method detected HCC nodules earlier, did not improve survival
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Despite success in detecting hepatocellular carcinoma nodules that conventional dynamic computed tomography failed to reveal, combined computed tomography with hepatic arteriography and arterial portography did not result in improved cumulative recurrence-free survival or overall survival, a recent study found.
The single-center, open-label, controlled trial randomly assigned 280 patients diagnosed with hepatocellular carcinoma (HCC) to combined computed tomography with hepatic arteriography and arterial portography (n=139; CTHA/CTAP) before radiofrequency ablation (RFA) or a control group between 2004 and 2009.
Use of CTHA/CTAP successfully diagnosed 75 new HCC nodules with a mean diameter of 8.7 mm in 45 patients (32.4%).
The differences in cumulative recurrence-free survival, the study’s primary endpoint, did not rise to statistical significance. The rates at 1, 2 and 3 years for the CTHA/CTAP group were 60.1%, 29% and 18.9%, respectively, compared with control rates of 52.2%, 29.7% and 23.1%, respectively (HR=0.94, 95% CI, 0.73-1.22).
The differences in overall survival, a key secondary endpoint, also were not significant. The rates for the CTHA/CTAP group were 79.7% and 56.4% at 3 and 5 years, respectively; control group rates were 86.8% and 60.1% (HR=1.15, 95% CI, 0.77-1.71).
“Our results may be extrapolated to other imaging modalities including gadoxetic acid–enhanced magnetic resonance imaging and second-generation contrast ultrasonography,” the researchers concluded. “These newly developed modalities also make possible the detection of small nodules that are invisible by dynamic CT. However, better diagnosis does not necessarily lead to better primary outcome.”
Disclosure: The researchers report no relevant financial disclosures.
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