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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
MeSH
Aged ; Carcinoma, Hepatocellular/mortality ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/therapy* ; Chemoembolization, Therapeutic/methods* ; Female ; Humans ; Kaplan-Meier Estimate ; Liver Neoplasms/mortality ; Liver Neoplasms/pathology ; Liver Neoplasms/therapy* ; Male ; Middle Aged ; Neoplasm Invasiveness ; Portal Vein/pathology ; Prognosis ; Proportional Hazards Models ; Remission Induction
Keywords
Best response ; Chemoembolization ; Hepatocellular carcinoma ; Initial response ; Prognosis
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
Kim, Do Young(김도영)
Kim, Man Deuk(김만득) ORCID logo https://orcid.org/0000-0002-3575-5847
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
Park, Sung Il(박성일)
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Lee, Do Yun(이도연)
Chung, Yong Eun(정용은) ORCID logo https://orcid.org/0000-0003-0811-9578
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/140392
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