Proliferative versus Nonproliferative Hepatocellular Carcinoma: Clinical and Imaging Implications
Menée à partir de données portant sur 158 patients atteints d'un carcinome hépatocellulaire traité par chirurgie entre 2010 et 2013 (âge moyen : 57 ans ; durée moyenne de suivi : 75,5 ans ; 128 hommes), cette étude met en évidence une association entre les caractéristiques d'un carcinome hépatocellulaire de classe proliférative déterminées au moyen d'une IRM avec rehaussement de contraste par gadoxétate et le pronostic après résection
Liver cancer is the second most common cause of cancer-related deaths worldwide, and is one of the few cancers with greatest increase in incidence and mortality over the past 2 decades (1). Hepatocellular carcinoma (HCC) accounts for 90% of primary liver cancers (1). The major risk factors associated with HCC include viral hepatitis (B and/or C), alcohol abuse, and nonalcoholic fatty liver disease. HCC is a highly heterogeneous cancer, both at the molecular and/or histologic level and in biologic behavior. Recent advances in molecular pathology have improved our understanding of the genetic landscape of HCCs. Molecular differences in tumors reflect the differing biologic behavior of tumors in the same clinical stage and may have implications on tailoring the therapies and predicting clinical outcomes (2). Indeed, genomic profiling has led to a paradigm shift in oncology research and clinical practice, such as in breast cancer, melanoma, and lung cancer wherein new treatment algorithms have improved patient outcomes. Based on genomic profiling and next-generation sequencing, several molecular classifications have been proposed for HCC with varied histologic features (S1–S3; G1-G6 classification) (3,4). Subsequently, two distinct subgroups of HCC (proliferative and nonproliferative) were identified, each with “core” genomic alterations and/or oncogenic pathways and distinct histopathologic features and clinical outcomes (4,5).
Radiology , éditorial, 2020