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Radiological-pathological correlation study of hepatocellular carcinoma undergoing local chemoradiotherapy and surgery

Authors
 Jun Won Kim  ;  Jinsil Seong  ;  Mi Sook Park  ;  Kyung Sik Kim  ;  Young Nyun Park  ;  Kwang Hyub Han  ;  Ki Chang Keum  ;  Ik Jae Lee 
Citation
 Journal of Gastroenterology and Hepatology, Vol.31(9) : 1619-1627, 2016 
Journal Title
 Journal of Gastroenterology and Hepatology 
ISSN
 0815-9319 
Issue Date
2016
Keywords
hepatocellular carcinoma ; localized chemoradiotherapy ; radiologic-pathologic correlation.
Abstract
BACKGROUND AND AIMS: Optimal response criteria and assessment timing were investigated through radiologic-pathologic correlation in hepatocellular carcinoma (HCC) treated with localized chemoradiotherapy (CRT). METHODS: We reviewed 19 consecutive HCC patients who underwent surgical resection after radiotherapy and concurrent hepatic arterial infusion chemotherapy. Patients who received transarterial chemoembolization before RT or surgery were excluded from evaluation. Tumor diameters and total and enhancing tumor volumes were measured from CT images obtained 1, 3, 6, and 9?months after CRT. Percent changes calculated using size (RECIST and WHO) and enhancement criteria (mRECIST and EASL) were correlated with percent changes in total and enhancing tumor volumes, and with percent viable tumor in surgical specimens. RESULTS: Median time between CRT and resection was 4.1?months (range, 1.5-15.4?months). CR and PR rates were 0 and 68% by RECIST, 0 and 63% by WHO, 53% and 37% by mRECIST, and 53% and 42% by EASL. Pathologic CR (pCR) rate was 52.6%. Radiologic criteria showed strong correlation with tumor volumes at 1 and 3?months after CRT; at 6?months, however, size and enhancement criteria showed strong correlation only with total and enhancing tumor volumes, respectively. Enhancement criteria were better predictors of pathologic response at all times including preoperative evaluation (RECIST: R(2) ?=?0.303, P?=?0.015 and WHO: R(2) ?=?0.366, P?=?0.006 vs. mRECIST: R(2) ?=?0.760, P?<?0.0001 and EASL: R(2) ?=?0.768, P?<?0.0001). Time interval >6?months before resection showed significant correlation with pCR (P?=?0.013). CONCLUSIONS: We recommend using enhancement criteria in assessing tumor viability, especially if the tumor was to be resected <6?months after CRT.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/jgh.13334/abstract
DOI
10.1111/jgh.13334
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
금기창(Keum, Ki Chang) ORCID logo https://orcid.org/0000-0003-4123-7998
김경식(Kim, Kyung Sik) ORCID logo https://orcid.org/0000-0001-9498-284X
김준원(Kim, Jun Won) ORCID logo https://orcid.org/0000-0003-1358-364X
박미숙(Park, Mi-Suk) ORCID logo https://orcid.org/0000-0001-5817-2444
박영년(Park, Young Nyun) ORCID logo https://orcid.org/0000-0003-0357-7967
성진실(Seong, Jin Sil) ORCID logo https://orcid.org/0000-0003-1794-5951
이익재(Lee, Ik Jae) ORCID logo https://orcid.org/0000-0001-7165-3373
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/22282913/152220
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