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Number of target lesions for EASL and modified RECIST to predict survivals in hepatocellular carcinoma treated with chemoembolization

Authors
 Beom Kyung Kim  ;  Seung Up Kim  ;  Myeong-Jin Kim  ;  Kyung Ah Kim  ;  Do Young Kim  ;  Jun Yong Park  ;  Sang Hoon Ahn  ;  Kwang-Hyub Han  ;  Chae Yoon Chon 
Citation
 CLINICAL CANCER RESEARCH, Vol.19(6) : 1503-1511, 2013 
Journal Title
 CLINICAL CANCER RESEARCH 
ISSN
 1078-0432 
Issue Date
2013
MeSH
Adult ; Aged ; Carcinoma, Hepatocellular/diagnosis ; Carcinoma, Hepatocellular/epidemiology* ; Carcinoma, Hepatocellular/pathology ; Chemoembolization, Therapeutic ; Europe ; Female ; Guidelines as Topic* ; Humans ; Liver Neoplasms/diagnosis ; Liver Neoplasms/epidemiology* ; Liver Neoplasms/pathology ; Male ; Middle Aged ; Prognosis ; Proportional Hazards Models ; Survival Analysis*
Keywords
Adult ; Aged ; Carcinoma, Hepatocellular/diagnosis ; Carcinoma, Hepatocellular/epidemiology* ; Carcinoma, Hepatocellular/pathology ; Chemoembolization, Therapeutic ; Europe ; Female ; Guidelines as Topic* ; Humans ; Liver Neoplasms/diagnosis ; Liver Neoplasms/epidemiology* ; Liver Neoplasms/pathology ; Male ; Middle Aged ; Prognosis ; Proportional Hazards Models ; Survival Analysis*
Abstract
PURPOSES: To date, most studies about the optimal number of target lesions for enhancement criteria for hepatocellular carcinoma (HCC) have focused on cross-sectional analyses of concordance. We investigated the optimal number of target lesions for European Association for the Study of the Liver (EASL) and modified Response Evaluation Criteria in Solid Tumors (mRECIST) guidelines in predicting overall survival (OS). EXPERIMENTAL DESIGN: We analyzed 254 consecutive treatment-naïve patients with HCC having at least 2 measurable target lesions undergoing transarterial chemoembolization. Kappa values for intermethod agreement of treatment responses were calculated for comparisons between use of maximum of 1, 2, 3, 4, or 5 targets versus use of all target lesions. Prognostic values of radiologic assessments according to number of target lesions for predicting OS were expressed as C-index. RESULTS: By EASL and mRECIST guidelines, κ values between responses assessing the longest 2, 3, 4, or 5 targets and assessing all targets were 0.924, 0.977, 1.000, or 1.000 and 0.907, 0.959, 1.000, or 1.000, respectively, whereas those between responses assessing only one target and assessing all target lesions were 0.723 and 0.666, respectively. C-index when measuring the longest 1, 2, 3, 4, 5, and all targets was similar, ranging from 0.739 to 0.749 for EASL criteria and from 0.750 to 0.759 for mRECIST. From Cox regression analyses, radiologic response from each calculation method showed independently significant effects on OS for both guidelines, regardless of number of target lesions. CONCLUSIONS: Prognostic values for predicting OS were similar regardless of number of target lesions. Assessing the 2 largest targets rather than only 1 index lesion could be recommended considering high concordances from cross-sectional analyses.
Files in This Item:
T201301627.pdf Download
DOI
10.1158/1078-0432.CCR-12-2721
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, Kyung Ah(김경아)
Kim, Do Young(김도영)
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/22282913/86926
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