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Complete response at first chemoembolization is still the most robust predictor for favorable outcome in hepatocellular carcinoma

Authors
 Beom Kyung Kim  ;  Seung Up Kim  ;  Kyung Ah Kim  ;  Yong Eun Chung  ;  Myeong Jin Kim  ;  Mi Suk Park  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Man Deuk Kim  ;  Sung Il Park  ;  Jong Yoon Won  ;  Do Yun Lee  ;  Kwang Hyub Han 
Citation
 Journal of Hepatology, Vol.62(6) : 1304-1310, 2015 
Journal Title
 Journal of Hepatology 
ISSN
 0168-8278 
Issue Date
2015
Abstract
BACKGROUNDS & AIMS: The aim of this study is to evaluate the prognostic significances of not only the initial and the best response during repeated transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC), but if eligible, also the time point of achieving treatment responses. METHODS: Three hundred and fourteen treatment-naïve patients with well-preserved liver function undergoing TACE were recruited. Treatment responses were assessed using modified Response Evaluation Criteria in Solid Tumors. Overall survival (OS) was analyzed using Kaplan-Meier methods, and Cox regression analysis was performed for multivariate analysis. RESULTS: After adjusting other variables, objective response (complete response [CR] and partial response [PR]) as the initial response (adjusted hazard ratio [HR] 0.410) and the best response (adjusted HR 0.335) had independent prognostic significances for OS, respectively (both p < 0.001). Objective responders as the initial response had the longest OS, followed by patients who subsequently achieved objective response after at least two sessions and those who did not achieve objective response during treatment course eventually (52.6, 27.0, and 10.8 months, respectively; log-rank test, p < 0.001). Likewise, patients with CR as the initial response had the longest OS, followed by those who subsequently achieved CR after at least two sessions and those who achieved PR as the best response (70.2, 40.6, and 23.0 months, respectively; log-rank test, p < 0.001). Large (>5 cm) and multiple (⩾ 4) tumors were independently associated with failure to achieve CR after the initial TACE (both p < 0.05). CONCLUSION: Both the initial and the best response predicts OS effectively. However, achievement of treatment response at an early time point is still the most robust predictor for favorable outcomes.
Full Text
http://www.sciencedirect.com/science/article/pii/S0168827815000537
DOI
10.1016/j.jhep.2015.01.022
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김도영(Kim, Do Young)
김만득(Kim, Man Deuk) ORCID logo https://orcid.org/0000-0002-3575-5847
김명진(Kim, Myeong Jin) ORCID logo https://orcid.org/0000-0001-7949-5402
김범경(Kim, Beom Kyung) ORCID logo https://orcid.org/0000-0002-5363-2496
김승업(Kim, Seung Up) ORCID logo https://orcid.org/0000-0002-9658-8050
박미숙(Park, Mi-Suk) ORCID logo https://orcid.org/0000-0001-5817-2444
박성일(Park, Sung Il)
박준용(Park, Jun Yong) ORCID logo https://orcid.org/0000-0001-6324-2224
안상훈(Ahn, Sang Hoon) ORCID logo https://orcid.org/0000-0002-3629-4624
원종윤(Won, Jong Yun) ORCID logo https://orcid.org/0000-0002-8237-5628
이도연(Lee, Do Yun)
정용은(Chung, Yong Eun) ORCID logo https://orcid.org/0000-0003-0811-9578
한광협(Han, Kwang-Hyub) ORCID logo https://orcid.org/0000-0003-3960-6539
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/140392
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