Survival benefits of computed tomography-guided thermal ablation for adrenal metastases from hepatocellular carcinoma

Figures & data

Figure 1. Patients selection flow and outcomes of CT-guided thermal ablation for adrenal metastases from HCC. CT: Computed Tomography; ECOG: Eastern Cooperative Oncology Group; HCC: Hepatocellular Carcinoma.

Table 1. Demographic characteristics of 27 patients and 29 adrenal metastatic tumors.

Variable	Total cohorts n (%)
Patient Characteristics (n = 27)
Age^a (years)	50 (34–77)
Gender
male	27 (100)
Etiology
Hepatitis B virus	25 (92.6)
Hepatitis C virus	1 (3.7)
Unknown	1 (3.7)
Child-Pugh class/score
A
5	21 (77.8)
6	4 (14.8)
B
7	2 (7.4)
ECOG performance status
0	14 (51.9)
1	13 (48.1)
A-fetoprotein level^a (ng/ml)	384.3 (1.7–5.4 × 10^4)
>400 ng/ml	14 (51.9)
<400 ng/ml	13 (48.1)
Intrahepatic tumor
Absent	15 (55.6)
Present	12 (44.4)
Portal vein thrombosis
Absent	21 (77.8)
Present	6 (22.2)
Extra-adrenal tumor
Absent	18 (66.7)
Present	9 (33.3)
Previous adrenal metastases
No	19 (70.4)
Yes	8 (29.6)
treatment
Surgery	4 (50)
Chemotherapy	3 (37.5)
Sorafenib	1 (12.5)
Adrenal tumor number
Single	25 (92.6)
Double
Ipsilateral	0 (0)
Contralateral	2 (7.4)
Adrenal tumor characteristics (n = 29)
Diameter of adrenal tumor
cm^a	3.5 (1.0–6.5)
cm^b	3.5 ± 1.7
No. of adrenal tumor	20 (64.5)
>3 cm	16 (55.2)
≤3 cm	13 (44.8)
Location of adrenal tumor
Right	16 (55.2)
Left	13 (44.8)

^a Data are expressed medians. Numbers in parentheses are ranges.

^b Data are expressed means ± standard deviation.

ECOG: Eastern Cooperative Oncology Group.

Figure 2. Outcome data for study population (two groups: adrenal oligometastases and multiple metastases). Swimmer’s plot showing disease progression reason, treatment for adrenal recurrence, time of survival and current status since the initial ablation of adrenal metastases.

Figure 3. Survival of the total 27 patients after thermal ablation for adrenal metastases from hepatocellular carcinoma. (A) Progression-free survival curve; (B) Overall survival curve.

Figure 4. Progression-free and overall survival between patients with adrenal oligometastases versus multiple metastases after thermal ablation. Kaplan-Meier curve of progression-free survival (A) and overall survival (B) CI: Confidence Interval; OS: Overall Survival; PFS: Progression-free Survival.

Table 2. Univariate analysis of prognostic factors that influenced overall survival.

		Univariate			Survival rate (%)
Variables	No. of Patients	HR (95%CI)	p value	Median survival (months)	6 months	12 months	24 months
Age (year)
≤50	14	1		12.8	85.7	57.1	7.1
>50	13	0.299 (0.119–0.748)	.010	41.9	84.6	69.2	52.7
ECOG performance status
0	14	1		20.2	85.7	71.4	35.7
1	13	1.156 (0.639–3.808)	.329	12.8	84.6	53.8	20.5
Child-Pugh class/score
5	21	1		20.2	50.0	0	0
6/7	6	2.065 (0.747–5.710)	.162	8	95.2	81.0	38.1
A-fetoprotein level (ng/mL)
≤400	13	1		13.5	92.9	57.1	26.8
>400	14	0.816 (0.363–1.832)	.621	17.9	76.9	69.2	30.8
Tumor diameter (cm)
≤3	11	1		28.5	90.9	90.9	45.5
>3	16	2.260 (0.949–5.382)	.065	10.9	81.3	43.8	18.8
Intrahepatic tumor
Absent	15	1		16.8	80.0	73.3	33.3
Present	12	1.154 (0.508–2.625)	.732	14.8	83.3	50.0	25.0
Portal vein thrombosis
Absent	21	1		21.8	90.5	76.2	42.9
Present	6	4.579 (1.559–13.446)	.006	10.6	66.7	16.7	0
Extra-adrenal tumor
Absent	18	1		21.8	88.9	66.7	44.4
Present	9	2.612 (1.030–6.627)	.043	12.8	77.8	55.6	0
Previous adrenal metastases
No	19	1		12.8	89.5	57.9	19.7
Yes	8	0.453 (0.178–1.156)	.098	28.5	75.0	75.0	50.0
Adrenal oligometastases
No	9	1		12.8	77.8	55.6	0
Yes	18	0.383 (0.151–0.971)	.043	21.8	88.9	66.7	44.4

CI: Confidence Interval; ECOG: Eastern Cooperative Oncology Group; HR: Hazard Ratio.

The bold value indicate statistically significant.