LI-RADS Classification and Outcomes of Hepatocellular Carcinoma Treated with Transcatheter Arterial Chemoembolization Combined with Radiofrequency Ablation

PurposeThe aim of this study was to clarify the usefulness of the Liver Imaging Reporting and Data System (LI-RADS) to predict the patients’ prognosis after transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (TACE-RFA) for hepatocellular carcinoma (HCC) of Barcelona-Clinic Liver Cancer Stage (BCLC) 0 or A.Materials and MethodsWe retrospectively analyzed cases of HCC patients who underwent TACE-RFA (Jan 2005 to Dec 2015). Patients’ nodules were categorized based on their LI-RADS v2018 core. The LI-RADS category was assigned to each nodule using dynamic contrast-enhanced CT. LR-3, LR-4 and LR-5 nodules were extracted. We assessed the overall survival (OS) and recurrence-free survival (RFS) among BCLC 0 and BCLC A patients.ResultsOf the 64 nodules extracted, 22 were LR-3 or -4 (14.8±6.7 mm) and 42 were LR-5 (17.1±6.9 mm). Regarding OS, there was no significant difference between LR-3 or -4 and LR-5 (p=0.278). In terms of RFS, there was a significant difference between LR-3 or -4 and LR-5 (p=0.03). In particular, patients with BCLC A with LR-5 nodules showed significantly poorer RFS than those with LR-3 or -4 (p=0.016) nodules. ConclusionsFor patients with BCLC A, LR-3 or -4 are associated with a better prognosis than LR-5 nodules.