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Prospective comparison of prognostic values of modified Response Evaluation Criteria in Solid Tumours with European Association for the Study of the Liver criteria in hepatocellular carcinoma following chemoembolisation

 Beom Kyung Kim  ;  Kyung Ah Kim  ;  Jun Yong Park  ;  Sang Hoon Ahn  ;  Chae Yoon Chon  ;  Kwang-Hyub Han  ;  Seung Up Kim  ;  Myeong-Jin Kim 
 European Journal of Cancer, Vol.49(4) : 826-834, 2013 
Journal Title
 European Journal of Cancer 
Issue Date
BACKGROUNDS: European Association for the Study of the Liver (EASL) and modified Response Evaluation Criteria in Solid Tumours (mRECIST) guidelines, which measure changes in arterialised hepatocellular carcinoma (HCC), differ in terms of number of target lesions (all versus ≤2) and calculation method (bidimensional versus unidimensional). We compared prognostic values of mRECIST for predicting overall survival (OS) with reference to EASL criteria in treatment-naïve HCC undergoing trans-arterial chemoembolisation (TACE). METHODS: The ability to predict OS during longitudinal follow-up was expressed as C-index, and a sample size of 292 patients was required to validate its equivalence between each criteria. Treatment responses were assessed using both guidelines 4weeks after the first TACE, using dynamic computed tomography or magnetic resonance imaging. Kaplan-Meier and Cox regression analyses were used to explore differences in OS between responders (complete or partial) and non-responders (stable or progressive disease), defined by each method. RESULTS: C-index for EASL and mRECIST guidelines was 0.753 and 0.759, respectively, demonstrating equivalence between two methods. Differences in median OS between responders and non-responders were statistically significant for both EASL (30.1 versus 18.7 months, p<0.001) and mRECIST (33.8 versus 17.1 months, p<0.001) guidelines. In addition to radiological response, α-fetoprotein (p<0.001), tumour number (p<0.001) and tumour size (p=0.048) were significant predictors of OS. In multivariate analysis, radiological criteria, tumour number and α-fetoprotein were identified as independent predictors (all p<0.05). CONCLUSION: mRECIST, a simpler method, provided prognostic values for predicting OS equivalent to EASL criteria in patients with HCC undergoing TACE as an initial treatment modality.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
Yonsei Authors
김경아(Kim, Kyung Ah)
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)
박준용(Park, Jun Yong) ORCID logo https://orcid.org/0000-0001-6324-2224
안상훈(Ahn, Sang Hoon)
전재윤(Chon, Chae Yoon)
한광협(Han, Kwang Hyup)
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