EASL and mRECIST responses are independent prognostic factors for survival in hepatocellular cancer patients treated with transarterial embolization

Gillmore, Roopinder; Stuart, Sam; Kirkwood, Amy A.; Hameeduddin, Ayshea; Woodward, Nick; Burroughs, Andrew K.; Meyer, Tim

doi:10.1016/j.jhep.2011.03.007

Cited by 291 publications

(248 citation statements)

References 18 publications

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“…Finally, the ART score was developed by using the radiologic EASL-response criteria. Although the prognostic performance of EASL criteria in the setting of TACE seems to be equal to the performance of mRECIST criteria, 25 the latter may be more adequate to dissect the prognosis of patients with partial response from that of subjects with stable disease. 26 This could rely on a different definition of partial response in the two models: greater than 50% tumor reduction for EASL and greater than 30% for mRECIST criteria.…”

Section: Discussionmentioning

confidence: 99%

The ART of decision making: Retreatment with transarterial chemoembolization in patients with hepatocellular carcinoma

et al. 2013

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We aimed to establish an objective point score to guide the decision for retreatment with transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). In all, 222 patients diagnosed with HCC and treated with multiple TACE cycles between January 1999 and December 2009 at the Departments of Gastroenterology/Hepatology of the Medical Universities of Vienna (training cohort) and Innsbruck (validation cohort) were included. We investigated the effect of the first TACE on parameters of liver function and tumor response and their impact on overall survival (OS, log rank test) and developed a point score (ART score: Assessment for Retreatment with TACE) in the training cohort (n 5 107, Vienna) by using a stepwise Cox regression model. The ART score was externally validated in an independent validation cohort (n 5 115, Innsbruck). The increase of aspartate aminotransferase (AST) by >25% (hazard ratio [HR] 8.4; P < 0.001), an increase of Child-Pugh score of 1 (HR 2.0) or !2 points (HR 4.4) (P < 0.001) from baseline, and the absence of radiologic tumor response (HR 1.7; P 5 0.026) remained independent negative prognostic factors for OS and were used to create the ART score. The ART score differentiated two groups (0-1.5 points; !2.5 points) with distinct prognosis (median OS: 23.7 versus 6.6 months; P < 0.001) and a higher ART score was associated with major adverse events after the second TACE (P 5 0.011). These results were confirmed in the external validation cohort and remained significant irrespective of ChildPugh stage and the presence of ascites prior the second TACE. Conclusion: An ART score of !2.5 prior the second TACE identifies patients with a dismal prognosis who may not profit from further TACE sessions. (HEPATOLOGY 2013;57:2261-2273

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Section: Discussionmentioning

confidence: 99%

The ART of decision making: Retreatment with transarterial chemoembolization in patients with hepatocellular carcinoma

et al. 2013

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“…• First, for overall survival, progression on the 2-3-month image is sufficient to provide information that the prognosis is poor [36].…”

Section: Clinical End Point Questionsmentioning

confidence: 99%

Computed Tomography Imaging Assessment of Postexternal Beam Radiation Changes of the Liver

et al. 2016

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Radiation is being used for patients with primary and secondary liver cancers, as a rapidly evolving treatment. However, postradiation imaging changes of the liver are not well understood and therefore challenging to interpret. Distinguishing normal radiation changes from residual or recurrent disease is difficult. Size and contrast enhancement have been used to guide interpretation and clinical recommendations, but normal radiation changes can make interpretation difficult and are not accounted for in available guidelines. Knowledge of dose- and time-dependent changes in addition to imaging findings, such as morphological and enhancement patterns, provides useful differentiating parameters. This paper reviews recent studies using computed tomography that can guide interpretation and help differentiate tumor from benign changes after external beam radiation.

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“…However, the introduction of molecular-targeted therapies has emphasized the limitations of RECIST in terms of their validity, because tumor response may be nondimensional, especially in an early phase. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] In these patients, tumor response is marked by changes in the tumor radiologic aspect and in its functional imaging.…”

Section: Introductionmentioning

confidence: 99%

Tumor response assessment by modified Choi criteria in localized high‐risk soft tissue sarcoma treated with chemotherapy

Stacchiotti

Verderio²,

Messina

et al. 2012

Cancer

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BACKGROUND. The objective of this study was to compare the prognostic relevance of Response Evaluation Criteria in Solid Tumors (RECIST) versus Choi criteria for the assessment of response in patients with high-risk soft tissue sarcoma of the extremities or trunk wall who received preoperative chemotherapy with or without radiotherapy in a phase 3 trial. METHODS. Patients received 3 cycles of preoperative epirubicin þ ifosfamide with or without radiotherapy. The diagnostic concordance between RECIST and Choi criteria and their correlation with overall survival (OS) and freedom from progression (FFP) were evaluated in a univariate Cox regression model. RESULTS. In 243 of 321 eligible patients, RECIST, Choi criteria, and histology were predictive for OS and FFP. In the subgroup of 69 patients who received chemotherapy alone and were evaluable by both RECIST and Choi criteria, Choi criteria were associated significantly with OS and FFP, whereas RECIST predicted only FFP, and the pattern of agreement observed between the 2 criteria was unsatisfactory. On a dichotomous scale, comparing objective response (complete and partial responses) and lack of response (stable and progressive disease) to preoperative chemotherapy according to RECIST and Choi criteria, only Choi criteria were predictive of OS and FFP, and fair agreement between RECIST and Choi criteria was observed. When lack of progression and progression were compared (complete and partial responses þ stable disease vs progressive disease), both assessment criteria were significantly predictive of OS and FFP, and there was substantial agreement between the 2 criteria. CONCLUSIONS. Response to chemotherapy with or without radiotherapy was associated with a better outcome in patients with high-risk soft tissue sarcoma. Choi criteria were better predictors than RECIST in patients who received preoperative chemotherapy alone. Cancer 2012;118:5857-66.

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EASL and mRECIST responses are independent prognostic factors for survival in hepatocellular cancer patients treated with transarterial embolization

Cited by 291 publications

References 18 publications

The ART of decision making: Retreatment with transarterial chemoembolization in patients with hepatocellular carcinoma

The ART of decision making: Retreatment with transarterial chemoembolization in patients with hepatocellular carcinoma

Computed Tomography Imaging Assessment of Postexternal Beam Radiation Changes of the Liver

Tumor response assessment by modified Choi criteria in localized high‐risk soft tissue sarcoma treated with chemotherapy

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