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

Andrew J. Gunn, Rahul A. Sheth, Brandon Luber, Minh Huy Huynh, Niranjan R. Rachamreddy, Sanjeeva P. Kalva

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Purpose: The 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 methods: Hospital 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). Results: 75 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). Conclusion: Current response criteria are not accurate predictors of OS or TTP in patients with advanced-stage HCC after DEB-TACE.

Original languageEnglish (US)
Pages (from-to)61-68
Number of pages8
JournalCardiovascular and Interventional Radiology
Volume40
Issue number1
DOIs
StatePublished - Jan 1 2017

Keywords

  • Hepatocellular carcinoma
  • Loco-regional therapy
  • Radiologic response criteria
  • Trans-arterial chemo-embolization

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Predicting Outcomes After Chemo-Embolization in Patients with Advanced-Stage Hepatocellular Carcinoma: An Evaluation of Different Radiologic Response Criteria'. Together they form a unique fingerprint.

Cite this