Prognosis value of liver stiffness measurements by 2D-SWE in primary HBV-positive hepatocellular carcinoma following radiofrequency ablation

Abstract

Background: Liver fibrosis is closely associated with the occurrence of hepatocellular carcinoma (HCC), which can be evaluated by liver stiffness measurements (LSM). The clinical significance of LSMin patient with hepatitis B virus (HBV) related HCC underwent radiofrequency ablation (RFA) was evaluated.

Methods: Total of 273 patients underwent RFA for primary HBV-positive HCC were included. LSM values were measured by using by 2D-shear wave elastography (2D-SWE) prior to RFA. The relationship between pretreatment LSM value and survival outcome was evaluated. The cutoff value for LSM to predict survival outcome was determined by receiver operating characteristic (ROC) curve analysis.

Results: At the endpoint of this study, 88 (32.2%) and 73 (26.7%) patients out of all 273 patients studied had died and recurrent, respectively. All patients were divided into two groups based on the cutoff value (13.4 kPa) of LSM. Patients with a LSM ≥13.4 kPa had lower mean overall survival (62.5 vs. 48.5 months, P=0.01) and lower recurrent free survival (60.4 vs. 47.3 months, P=0.02) than patients with a LSM <13.4 kPa in univariate analysis and LSM also been evaluated as independent predictive factor for survival outcome for HCC following RFA. Otherwise, LSM also was related to liver cirrhosis and TNM stage (both P<0.05).

Conclusions: LSM measured by 2D-SWE can sever as an independent prognostic indictor for patients undergoing RFA for HBV-positive HCC.

Keywords: Liver stiffness; hepatitis B virus (HBV); hepatocellular carcinoma (HCC); prognosis; radiofrequency ablation.

Figure 1

Receiver-operator characteristic curve for LSM measured by 2D-SWE. the AUC were 0.81 with a 95% CI between 0.70 and 0.92, P<0.01.

Figure 2

Kaplan–Meier estimates of survival. (A) Patients with a high LSM level had a poorer OS than those with a low LSM level (62.5 vs. 48.5 months, P=0.01). (B) Patients with a high LSM level had a poorer OS than those with a low LSM level (60.4 vs. 47.3 months, P=0.02).