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Pretreatment assessment of tumor enhancement on contrast-enhanced computed tomography as a potential predictor of treatment outcome in metastatic renal cell carcinoma patients receiving antiangiogenic therapy

 Kyung Seok Han  ;  Dae Chul Jung  ;  Hyuck Jae Choi  ;  Min Soo Jeong  ;  Kang Su Cho  ;  Jae Young Joung  ;  Ho Kyung Seo  ;  Kang Hyun Lee  ;  Jinsoo Chung 
 CANCER, Vol.116(10) : 2332-2342, 2010 
Journal Title
Issue Date
Adult ; Aged ; Angiogenesis Inhibitors/therapeutic use* ; Carcinoma, Renal Cell/diagnostic imaging ; Contrast Media ; Disease Progression ; Drug Delivery Systems ; Female ; Humans ; Kidney Neoplasms/diagnostic imaging* ; Kidney Neoplasms/drug therapy* ; Male ; Middle Aged ; Neoplasm Metastasis/diagnostic imaging* ; Protein Kinase Inhibitors/therapeutic use ; Tomography, X-Ray Computed/methods* ; Treatment Outcome
renal cell carcinoma ; metastasis ; targeted therapy ; computed tomography ; attenuation ; contrast enhancement ; response ; prognosis
BACKGROUND: Tumor vascularity is a potential predictor of treatment outcomes in metastatic renal cell carcinoma (mRCC), and contrast enhancement of tumors in computed tomography (CT) is correlated significantly with microvessel density. In this study, the authors investigated whether tumor enhancement in contrast-enhanced CT (CECT) is useful for predicting outcomes in patients with mRCC who are receiving antiangiogenic therapy. METHODS: Attenuation values were reviewed retrospectively on CECT images of all metastatic lesions in 66 patients from February 2007 to November 2008. All patients received a tyrosine kinase inhibitor (either sunitinib or sorafenib). Tumor response was evaluated on CECT studies every 12 weeks. The authors analyzed the association between contrast enhancement and treatment outcomes, including objective response, tumor size reduction rate, time to response, and time to progression. RESULTS: In 46 patients, 198 metastatic lesions were assessed. Tumor size was reduced in 140 lesions (70.7%) and was increased in 58 lesions (29.3%). The mean reduction in size was 23.8%. The overall mean time to response and the time to progression were 8.6 months and 16.4 months, respectively. In multivariate analyses, tumor enhancement and enhancement pattern were associated with objective responses (P = .003 and P = .028, respectively). In addition, tumor enhancement was associated with tumor size reduction (P = .004). In Cox proportional hazards models, only tumor enhancement was associated significantly with the time to size reduction and progression-free survival (P = .03 and P = .015, respectively). CONCLUSIONS: Tumor enhancement on CECT images was associated with treatment outcomes and was identified as a potential predictor of treatment outcomes after antiangiogenic therapy in patients with mRCC.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Cho, Kang Su(조강수) ORCID logo https://orcid.org/0000-0002-3500-8833
Han, Kyung Seok(한경석)
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