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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

Authors
 Beom Kyung Kim  ;  Kyung Ah Kim  ;  Jun Yong Park  ;  Sang Hoon Ahn  ;  Chae Yoon Chon  ;  Kwang-Hyub Han  ;  Seung Up Kim  ;  Myeong-Jin Kim 
Citation
 EUROPEAN JOURNAL OF CANCER, Vol.49(4) : 826-834, 2013 
Journal Title
EUROPEAN JOURNAL OF CANCER
ISSN
 0959-8049 
Issue Date
2013
MeSH
Adult ; Aged ; Carcinoma, Hepatocellular/mortality ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/therapy* ; Chemoembolization, Therapeutic* ; Female ; Follow-Up Studies ; Humans ; Liver Function Tests ; Liver Neoplasms/mortality ; Liver Neoplasms/pathology ; Liver Neoplasms/therapy* ; Longitudinal Studies ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; Survival Rate ; Tomography, X-Ray Computed ; alpha-Fetoproteins/metabolism
Keywords
mRECIST ; EASL ; Overall survival ; Prediction ; Equivalence
Abstract
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.
Full Text
http://www.sciencedirect.com/science/article/pii/S0959804912006843
DOI
10.1016/j.ejca.2012.08.022
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Ah(김경아)
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, 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
Chon, Chae Yoon(전재윤)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86592
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