Predicting Outcomes After Chemo-Embolization in Patients with Advanced-Stage Hepatocellular Carcinoma: An Evaluation of Different Radiologic Response Criteria

Journal Article · Sun Jan 15 04:00:00 EST 2017 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-016-1451-X· OSTI ID:22645366

Sheth, Rahul A. ^[1]; Luber, Brandon ^[2]; Huynh, Minh-Huy ^[3]; Rachamreddy, Niranjan R. ^[4]; Kalva, Sanjeeva P. ^[5]

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1. MD Anderson Cancer Center, Division of Interventional Radiology (United States)
2. Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Divison of Biostatistics and Bioinformatics (United States)
3. Johns Hopkins University School of Medicine (United States)
4. Massachusetts General Hospital/Harvard Medical School, Department of Radiology (United States)
5. University of Texas Southwestern Medical Center, Division of Interventional Radiology, Department of Radiology (United States)

PurposeThe purpse of this study was to evaluate the ability of various radiologic response criteria to predict patient outcomes after trans-arterial chemo-embolization with drug-eluting beads (DEB-TACE) in patients with advanced-stage (BCLC C) hepatocellular carcinoma (HCC).Materials and methodsHospital records from 2005 to 2011 were retrospectively reviewed. Non-infiltrative lesions were measured at baseline and on follow-up scans after DEB-TACE according to various common radiologic response criteria, including guidelines of the World Health Organization (WHO), Response Evaluation Criteria in Solid Tumors (RECIST), the European Association for the Study of the Liver (EASL), and modified RECIST (mRECIST). Statistical analysis was performed to see which, if any, of the response criteria could be used as a predictor of overall survival (OS) or time-to-progression (TTP).Results75 patients met inclusion criteria. Median OS and TTP were 22.6 months (95 % CI 11.6–24.8) and 9.8 months (95 % CI 7.1–21.6), respectively. Univariate and multivariate Cox analyses revealed that none of the evaluated criteria had the ability to be used as a predictor for OS or TTP. Analysis of the C index in both univariate and multivariate models showed that the evaluated criteria were not accurate predictors of either OS (C-statistic range: 0.51–0.58 in the univariate model; range: 0.54–0.58 in the multivariate model) or TTP (C-statistic range: 0.55–0.59 in the univariate model; range: 0.57–0.61 in the multivariate model).ConclusionCurrent response criteria are not accurate predictors of OS or TTP in patients with advanced-stage HCC after DEB-TACE.

• OSTI ID: 22645366
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 1 Vol. 40; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
DRUGS
EVALUATION
HEPATOMAS
LIVER
MULTIVARIATE ANALYSIS
PATIENTS
RECOMMENDATIONS
REVIEWS
VASCULAR DISEASES