Comparison of the methods for tumor response assessment in patients with hepatocellular carcinoma undergoing transarterial chemoembolization

Eun Suk Jung, Ji Hoon Kim, Eileen L. Yoon, Hyun Jung Lee, Soon Jae Lee, Sang Jun Suh, Beomjae Lee, Yeon Seok Seo, Hyung Joon Yim, Tae-Seok Seo, Chang-Hee Lee, Jong Eun Yeon, Jong Jae Park, Jae Seon Kim, Young-Tae Bak, Kwan Soo Byun

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Abstract

Background & Aims: Recently, new methods, including the concept of viable enhancing tumor such as EASL and mRECIST, have been proposed for substitution of the conventional WHO and RECIST criteria in hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). Herein, we evaluated the differences of four methods and compared the association of these methods with the prognosis of HCC patients undergoing TACE. Methods: We retrospectively reviewed 114 consecutive newly diagnosed HCC patients who underwent TACE as initial treatment. We evaluated the intermethod agreement (κ values) between the methods and compared their association with the prognosis of HCC patients. Results: The κ values for EASL vs. WHO, EASL vs. RECIST, mRECIST vs. WHO, and mRECIST vs. RECIST were low, of 0.102, 0.088, 0.112, and 0.122, respectively. However, good correlations were observed for WHO vs. RECIST and EASL vs. mRECIST (κ = 0.883, κ = 0.759, respectively p <0.001). The median OS was 32.3 months. Hazard ratios (HR) for survival in responders compared with non-responders were 0.21 (95% CI; 0.12-0.37, p <0.001) for EASL and 0.27 (95% CI; 0.15-0.48, p <0.001) for mRECIST. The mean survival of responders was significantly longer than that of non-responders in both EASL (40.8 vs. 16.9 months, p <0.001) and mRECIST (41.1 vs. 20.7 months, p <0.001). In multivariate analysis, EASL response (HR 0.21, 95% CI 0.11-0.40, p <0.001) and mRECIST response (HR; 0.31, 95% CI, 0.17-0.59, p <0.001) were independently associated with survival. Conclusions: The response assessment by EASL and mRECIST could reliably predict the survival of HCC patients undergoing TACE and could be applicable in practice in preference to the conventional WHO and RECIST criteria.

Original languageEnglish
Pages (from-to)1181-1187
Number of pages7
JournalJournal of Hepatology
Volume58
Issue number6
DOIs
Publication statusPublished - 2013 Jun 1

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Hepatocellular Carcinoma
Survival
Neoplasms
Multivariate Analysis
Response Evaluation Criteria in Solid Tumors
Therapeutics

Keywords

  • Hepatocellular carcinoma
  • Response
  • Survival
  • Transarterial chemoembolization

ASJC Scopus subject areas

  • Hepatology

Cite this

@article{3880f04c56c64b82aa8f6b30a0cfed47,
title = "Comparison of the methods for tumor response assessment in patients with hepatocellular carcinoma undergoing transarterial chemoembolization",
abstract = "Background & Aims: Recently, new methods, including the concept of viable enhancing tumor such as EASL and mRECIST, have been proposed for substitution of the conventional WHO and RECIST criteria in hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). Herein, we evaluated the differences of four methods and compared the association of these methods with the prognosis of HCC patients undergoing TACE. Methods: We retrospectively reviewed 114 consecutive newly diagnosed HCC patients who underwent TACE as initial treatment. We evaluated the intermethod agreement (κ values) between the methods and compared their association with the prognosis of HCC patients. Results: The κ values for EASL vs. WHO, EASL vs. RECIST, mRECIST vs. WHO, and mRECIST vs. RECIST were low, of 0.102, 0.088, 0.112, and 0.122, respectively. However, good correlations were observed for WHO vs. RECIST and EASL vs. mRECIST (κ = 0.883, κ = 0.759, respectively p <0.001). The median OS was 32.3 months. Hazard ratios (HR) for survival in responders compared with non-responders were 0.21 (95{\%} CI; 0.12-0.37, p <0.001) for EASL and 0.27 (95{\%} CI; 0.15-0.48, p <0.001) for mRECIST. The mean survival of responders was significantly longer than that of non-responders in both EASL (40.8 vs. 16.9 months, p <0.001) and mRECIST (41.1 vs. 20.7 months, p <0.001). In multivariate analysis, EASL response (HR 0.21, 95{\%} CI 0.11-0.40, p <0.001) and mRECIST response (HR; 0.31, 95{\%} CI, 0.17-0.59, p <0.001) were independently associated with survival. Conclusions: The response assessment by EASL and mRECIST could reliably predict the survival of HCC patients undergoing TACE and could be applicable in practice in preference to the conventional WHO and RECIST criteria.",
keywords = "Hepatocellular carcinoma, Response, Survival, Transarterial chemoembolization",
author = "Jung, {Eun Suk} and Kim, {Ji Hoon} and Yoon, {Eileen L.} and Lee, {Hyun Jung} and Lee, {Soon Jae} and Suh, {Sang Jun} and Beomjae Lee and Seo, {Yeon Seok} and Yim, {Hyung Joon} and Tae-Seok Seo and Chang-Hee Lee and Yeon, {Jong Eun} and Park, {Jong Jae} and Kim, {Jae Seon} and Young-Tae Bak and Byun, {Kwan Soo}",
year = "2013",
month = "6",
day = "1",
doi = "10.1016/j.jhep.2013.01.039",
language = "English",
volume = "58",
pages = "1181--1187",
journal = "Journal of Hepatology",
issn = "0168-8278",
publisher = "Elsevier",
number = "6",

}

TY - JOUR

T1 - Comparison of the methods for tumor response assessment in patients with hepatocellular carcinoma undergoing transarterial chemoembolization

AU - Jung, Eun Suk

AU - Kim, Ji Hoon

AU - Yoon, Eileen L.

AU - Lee, Hyun Jung

AU - Lee, Soon Jae

AU - Suh, Sang Jun

AU - Lee, Beomjae

AU - Seo, Yeon Seok

AU - Yim, Hyung Joon

AU - Seo, Tae-Seok

AU - Lee, Chang-Hee

AU - Yeon, Jong Eun

AU - Park, Jong Jae

AU - Kim, Jae Seon

AU - Bak, Young-Tae

AU - Byun, Kwan Soo

PY - 2013/6/1

Y1 - 2013/6/1

N2 - Background & Aims: Recently, new methods, including the concept of viable enhancing tumor such as EASL and mRECIST, have been proposed for substitution of the conventional WHO and RECIST criteria in hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). Herein, we evaluated the differences of four methods and compared the association of these methods with the prognosis of HCC patients undergoing TACE. Methods: We retrospectively reviewed 114 consecutive newly diagnosed HCC patients who underwent TACE as initial treatment. We evaluated the intermethod agreement (κ values) between the methods and compared their association with the prognosis of HCC patients. Results: The κ values for EASL vs. WHO, EASL vs. RECIST, mRECIST vs. WHO, and mRECIST vs. RECIST were low, of 0.102, 0.088, 0.112, and 0.122, respectively. However, good correlations were observed for WHO vs. RECIST and EASL vs. mRECIST (κ = 0.883, κ = 0.759, respectively p <0.001). The median OS was 32.3 months. Hazard ratios (HR) for survival in responders compared with non-responders were 0.21 (95% CI; 0.12-0.37, p <0.001) for EASL and 0.27 (95% CI; 0.15-0.48, p <0.001) for mRECIST. The mean survival of responders was significantly longer than that of non-responders in both EASL (40.8 vs. 16.9 months, p <0.001) and mRECIST (41.1 vs. 20.7 months, p <0.001). In multivariate analysis, EASL response (HR 0.21, 95% CI 0.11-0.40, p <0.001) and mRECIST response (HR; 0.31, 95% CI, 0.17-0.59, p <0.001) were independently associated with survival. Conclusions: The response assessment by EASL and mRECIST could reliably predict the survival of HCC patients undergoing TACE and could be applicable in practice in preference to the conventional WHO and RECIST criteria.

AB - Background & Aims: Recently, new methods, including the concept of viable enhancing tumor such as EASL and mRECIST, have been proposed for substitution of the conventional WHO and RECIST criteria in hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). Herein, we evaluated the differences of four methods and compared the association of these methods with the prognosis of HCC patients undergoing TACE. Methods: We retrospectively reviewed 114 consecutive newly diagnosed HCC patients who underwent TACE as initial treatment. We evaluated the intermethod agreement (κ values) between the methods and compared their association with the prognosis of HCC patients. Results: The κ values for EASL vs. WHO, EASL vs. RECIST, mRECIST vs. WHO, and mRECIST vs. RECIST were low, of 0.102, 0.088, 0.112, and 0.122, respectively. However, good correlations were observed for WHO vs. RECIST and EASL vs. mRECIST (κ = 0.883, κ = 0.759, respectively p <0.001). The median OS was 32.3 months. Hazard ratios (HR) for survival in responders compared with non-responders were 0.21 (95% CI; 0.12-0.37, p <0.001) for EASL and 0.27 (95% CI; 0.15-0.48, p <0.001) for mRECIST. The mean survival of responders was significantly longer than that of non-responders in both EASL (40.8 vs. 16.9 months, p <0.001) and mRECIST (41.1 vs. 20.7 months, p <0.001). In multivariate analysis, EASL response (HR 0.21, 95% CI 0.11-0.40, p <0.001) and mRECIST response (HR; 0.31, 95% CI, 0.17-0.59, p <0.001) were independently associated with survival. Conclusions: The response assessment by EASL and mRECIST could reliably predict the survival of HCC patients undergoing TACE and could be applicable in practice in preference to the conventional WHO and RECIST criteria.

KW - Hepatocellular carcinoma

KW - Response

KW - Survival

KW - Transarterial chemoembolization

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U2 - 10.1016/j.jhep.2013.01.039

DO - 10.1016/j.jhep.2013.01.039

M3 - Article

VL - 58

SP - 1181

EP - 1187

JO - Journal of Hepatology

JF - Journal of Hepatology

SN - 0168-8278

IS - 6

ER -