Does Establishing a Safety Margin Reduce Local Recurrence in Subsegmental Transarterial Chemoembolization for Small Nodular XXXX ?

@entity5 @entity1 @entity157 @entity4831
OBJECTIVE: To test the hypothesis that a safety margin may affect local @entity5 recurrence (LTR) in subsegmental chemoembolization. MATERIALS AND METHODS: In 101 @entity1 with 128 @entity157 ( @entity157 ) nodules (1-3 cm in size and  <= 3 in number), cone-beam CT-assisted subsegmental @entity4831 chemoembolization was performed. Immediately thereafter, a non-contrast thin-section CT image was obtained to evaluate the presence or absence of intra-tumoral @entity4831 uptake defect and safety margin. The effect of @entity4831 uptake defect and safety margin on LTR was evaluated. Univariate and multivariate analyses were performed to indentify determinant factors of LTR. RESULTS: Of the 128 @entity157 nodules in 101 @entity1 , 49 (38.3%) nodules in 40 @entity1 showed LTR during follow-up period (median, 34.1 months). Cumulative 1- and 2-year LTR rates of nodules with @entity4831 uptake defect (n = 27) and those without defect (n = 101) were 58.1% vs. 10.1% and 72.1% vs. 19.5%, respectively (p < 0.001). Among the 101 nodules without a defect, the 1- and 2-year cumulative LTR rates for nodules with complete safety margin (n = 52) and those with incomplete safety margin (n = 49) were 9.8% vs. 12.8% and 18.9% vs. 19.0% (p = 0.912). In multivariate analyses, ascites (p = 0.035), indistinct @entity5 margin on cone-beam CT (p = 0.039), heterogeneous @entity4831 uptake (p = 0.023), and intra-tumoral @entity4831 uptake defect (p < 0.001) were determinant factors of higher LTR. CONCLUSION: In @entity4831 chemoembolization, the safety margin in completely lipiodolized nodule without defect will not affect LTR in small nodular HCCs.
