Background
Incidental detection of nonenhancing tumors during imaging studies for patients with
classical hepatocellular carcinoma is not unusual. These tumors are considered to
have a high potential of malignant transformation. The aim of this study was to clarify
the natural history of such tumors.
Methods
In 93 patients who underwent liver resection for hepatocellular carcinoma, 138 nonenhancing
or enhancing nodules without washout were detected during dynamic computed tomography
and observed without further treatments. We subsequently compared the cumulative occurrence
of new hepatocellular carcinomas to that of the malignant transformation of these
lesions. We additionally compared the appearance of new hepatocellular carcinomas
between the patients with (n = 93) and without (n = 782) nonenhancing lesions or enhancing lesions without washout.
Results
After a median follow-up period of 0.7 years (range, 0.2–6.8), the median intervals
from resection to the appearance of new classical hepatocellular carcinoma and malignant
transformation of nonenhancing lesions or enhancing lesions without washout were 1.6 years
(95% confidence interval, 1.2–1.9) and 2.3 years (1.9–6.8 years; P = .002), respectively. On the other hand, the median intervals from resection to
the appearance of new lesions in patients with and without nonenhancing lesions or
enhancing lesions without washout were 1.6 years (95% confidence interval, 1.2–1.9)
and 2.1 years (1.9–2.1 years; P = .031), respectively.
Conclusion
During the natural history of nonenhancing lesions and enhancing lesions without washout
that coexist with hepatocellular carcinoma, new lesions often develop prior to the
malignant transformation of these lesions. This should be considered a risk factor
for the appearance of new hepatocellular carcinoma.
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Article info
Publication history
Published online: June 03, 2016
Accepted:
April 13,
2016
Footnotes
Supported by a Grant-in-Aid for Scientific Research (C) 15K10152 from the Ministry of Education, Culture, Sports, Science and Technology, Japan.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
