Radiologic Response as a Prognostic Factor in Advanced Hepatocellular Carcinoma with Macroscopic Vascular Invasion after Transarterial Chemoembolization and Radiotherapy
Introduction: We evaluated the radiologic response rate of combined transarterial chemoembolization (TACE) plus radiotherapy (RT) in treatment-naïve patients with liver-confined hepatocellular carcinoma (HCC) with macroscopic vascular invasion (MVI) and analyzed its clinical importance in overall su...
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| Veröffentlicht in: | Liver cancer (Basel ) 2022-04, Vol.11 (2), p.152-161 |
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| creator | Jung, Jinhong Joo, Ji Hyeon Kim, So Yeon Kim, Jin Hyoung Choi, Jonggi Lee, Danbi Shim, Ju Hyun Kim, Kang Mo Lim, Young-Suk Lee, Han Chu Park, Jin-hong Yoon, Sang Min |
| description | Introduction: We evaluated the radiologic response rate of combined transarterial chemoembolization (TACE) plus radiotherapy (RT) in treatment-naïve patients with liver-confined hepatocellular carcinoma (HCC) with macroscopic vascular invasion (MVI) and analyzed its clinical importance in overall survival (OS) outcomes. Methods: Patients who were treated with TACE plus RT as a first-line treatment for HCC with MVI between January 2010 and December 2015 were retrospectively reviewed. Radiologic response was assessed according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) at 2 and 4 months after completion of RT. Landmark analysis at 2 and 4 months, and time-dependent Cox regression analysis using response as a time-dependent covariate were performed for univariable and multivariable analyses. Results: The 2-month landmark analysis included 427 patients, and the 4-month landmark analysis included 355 patients after excluding patients without imaging studies for response evaluation at 4 months. Radiologic responses were observed in 210 (49.2%) patients at 2 months and 181 (51.8%) patients at 4 months. In multivariable analyses, radiologic response was identified as an independent prognosticator for OS at 2 months (median OS: responders, 23.1 months vs. nonresponders, 8.0 months; hazard ratio [HR], 3.194; p < 0.001) and 4 months (median OS: responders, 26.5 months vs. nonresponders, 9.3 months; HR, 4.534; p < 0.001). Conclusion: Radiologic response assessed by mRECIST was a significant prognostic factor for OS in patients with advanced-stage HCC showing MVI treated with combined TACE plus RT. |
| doi_str_mv | 10.1159/000521227 |
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Methods: Patients who were treated with TACE plus RT as a first-line treatment for HCC with MVI between January 2010 and December 2015 were retrospectively reviewed. Radiologic response was assessed according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) at 2 and 4 months after completion of RT. Landmark analysis at 2 and 4 months, and time-dependent Cox regression analysis using response as a time-dependent covariate were performed for univariable and multivariable analyses. Results: The 2-month landmark analysis included 427 patients, and the 4-month landmark analysis included 355 patients after excluding patients without imaging studies for response evaluation at 4 months. Radiologic responses were observed in 210 (49.2%) patients at 2 months and 181 (51.8%) patients at 4 months. In multivariable analyses, radiologic response was identified as an independent prognosticator for OS at 2 months (median OS: responders, 23.1 months vs. nonresponders, 8.0 months; hazard ratio [HR], 3.194; p < 0.001) and 4 months (median OS: responders, 26.5 months vs. nonresponders, 9.3 months; HR, 4.534; p < 0.001). Conclusion: Radiologic response assessed by mRECIST was a significant prognostic factor for OS in patients with advanced-stage HCC showing MVI treated with combined TACE plus RT.</description><identifier>ISSN: 2235-1795</identifier><identifier>EISSN: 1664-5553</identifier><identifier>DOI: 10.1159/000521227</identifier><identifier>PMID: 35634423</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>Cancer therapies ; Care and treatment ; Chemoembolization ; Disease ; Embolization ; Hepatoma ; Liver ; Liver cancer ; Medical prognosis ; Medical research ; Medicine, Experimental ; Metastasis ; Prognosis ; Radiation therapy ; Radiotherapy ; Research Article ; Respiration ; Response rates ; Thrombosis ; Tumors ; Veins & arteries</subject><ispartof>Liver cancer (Basel ), 2022-04, Vol.11 (2), p.152-161</ispartof><rights>2021 The Author(s) Published by S. Karger AG, Basel</rights><rights>Copyright © 2021 by S. Karger AG, Basel.</rights><rights>COPYRIGHT 2022 S. Karger AG</rights><rights>2021 The Author(s) Published by S. Karger AG, Basel . This work is licensed under the Creative Commons Attribution – Non-Commercial License http://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright © 2021 by S. Karger AG, Basel 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c585t-6be679df3da3c55bd598dd203f38d1e71991d4d76b9b54df01a1a69ebb043ff33</citedby><cites>FETCH-LOGICAL-c585t-6be679df3da3c55bd598dd203f38d1e71991d4d76b9b54df01a1a69ebb043ff33</cites><orcidid>0000-0001-9275-3197 ; 0000-0002-7300-6396 ; 0000-0002-7631-4124 ; 0000-0002-1544-577X ; 0000-0002-5138-3051 ; 0000-0002-7336-1371 ; 0000-0002-3180-3178</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9109074/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9109074/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,27614,27903,27904,53770,53772</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35634423$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jung, Jinhong</creatorcontrib><creatorcontrib>Joo, Ji Hyeon</creatorcontrib><creatorcontrib>Kim, So Yeon</creatorcontrib><creatorcontrib>Kim, Jin Hyoung</creatorcontrib><creatorcontrib>Choi, Jonggi</creatorcontrib><creatorcontrib>Lee, Danbi</creatorcontrib><creatorcontrib>Shim, Ju Hyun</creatorcontrib><creatorcontrib>Kim, Kang Mo</creatorcontrib><creatorcontrib>Lim, Young-Suk</creatorcontrib><creatorcontrib>Lee, Han Chu</creatorcontrib><creatorcontrib>Park, Jin-hong</creatorcontrib><creatorcontrib>Yoon, Sang Min</creatorcontrib><title>Radiologic Response as a Prognostic Factor in Advanced Hepatocellular Carcinoma with Macroscopic Vascular Invasion after Transarterial Chemoembolization and Radiotherapy</title><title>Liver cancer (Basel )</title><addtitle>Liver Cancer</addtitle><description>Introduction: We evaluated the radiologic response rate of combined transarterial chemoembolization (TACE) plus radiotherapy (RT) in treatment-naïve patients with liver-confined hepatocellular carcinoma (HCC) with macroscopic vascular invasion (MVI) and analyzed its clinical importance in overall survival (OS) outcomes. Methods: Patients who were treated with TACE plus RT as a first-line treatment for HCC with MVI between January 2010 and December 2015 were retrospectively reviewed. Radiologic response was assessed according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) at 2 and 4 months after completion of RT. Landmark analysis at 2 and 4 months, and time-dependent Cox regression analysis using response as a time-dependent covariate were performed for univariable and multivariable analyses. Results: The 2-month landmark analysis included 427 patients, and the 4-month landmark analysis included 355 patients after excluding patients without imaging studies for response evaluation at 4 months. Radiologic responses were observed in 210 (49.2%) patients at 2 months and 181 (51.8%) patients at 4 months. In multivariable analyses, radiologic response was identified as an independent prognosticator for OS at 2 months (median OS: responders, 23.1 months vs. nonresponders, 8.0 months; hazard ratio [HR], 3.194; p < 0.001) and 4 months (median OS: responders, 26.5 months vs. nonresponders, 9.3 months; HR, 4.534; p < 0.001). Conclusion: Radiologic response assessed by mRECIST was a significant prognostic factor for OS in patients with advanced-stage HCC showing MVI treated with combined TACE plus RT.</description><subject>Cancer therapies</subject><subject>Care and treatment</subject><subject>Chemoembolization</subject><subject>Disease</subject><subject>Embolization</subject><subject>Hepatoma</subject><subject>Liver</subject><subject>Liver cancer</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Metastasis</subject><subject>Prognosis</subject><subject>Radiation therapy</subject><subject>Radiotherapy</subject><subject>Research Article</subject><subject>Respiration</subject><subject>Response rates</subject><subject>Thrombosis</subject><subject>Tumors</subject><subject>Veins & arteries</subject><issn>2235-1795</issn><issn>1664-5553</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>M--</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>DOA</sourceid><recordid>eNptkk1vEzEQhlcIRKvSA3eELPUChxR7vV6vL0hRRGmkIlBVuFqz_kgcdu2tvSkq_4h_iZOUqEGVD7Zmnnnnw1MUrwk-J4SJDxhjVpKy5M-KY1LX1YQxRp8Xx2VJ2YRwwY6K05RWGcMNxlzwl8URZTWtqpIeF3-uQbvQhYVT6NqkIfhkECQE6FsMCx_SmB0XoMYQkfNoqu_AK6PRpRlgDMp03bqDiGYQlfOhB_TLjUv0BVQMSYUhB_-ApLbM3N9BcsEjsKOJ6CaCTxDz00GHZkvTB9O3oXO_YdxSXqNtcePSRBjuXxUvLHTJnD7cJ8X3i083s8vJ1dfP89n0aqJYw8ZJ3ZqaC22pBqoYazUTjdYlppY2mhhOhCC60rxuRcsqbTEBArUwbYsrai2lJ8V8p6sDrOQQXQ_xXgZwcmsIcSFz1U51RjLdlITnvAJYVakWBLGNpbYloITFG62PO61h3fZGK-PHCN2B6KHHu6VchDspCBaYV1ng3YNADLdrk0bZu7SZOngT1kmW9aYhnlcgo2f_oauwjj6PSpYCY0o4Lh9RC8gNOG9Dzqs2onLKy1o0nNdNps6foPLRpncqeGNdth8EvN8FbP49RWP3PRIsN2sq92ua2bePh7In_y1lBt7sgJ8QFybugX382ZPuq_lsR8ghf_9fuqn50g</recordid><startdate>20220401</startdate><enddate>20220401</enddate><creator>Jung, Jinhong</creator><creator>Joo, Ji Hyeon</creator><creator>Kim, So Yeon</creator><creator>Kim, Jin Hyoung</creator><creator>Choi, Jonggi</creator><creator>Lee, Danbi</creator><creator>Shim, Ju Hyun</creator><creator>Kim, Kang Mo</creator><creator>Lim, Young-Suk</creator><creator>Lee, Han Chu</creator><creator>Park, Jin-hong</creator><creator>Yoon, Sang Min</creator><general>S. Karger AG</general><general>Karger Publishers</general><scope>M--</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-9275-3197</orcidid><orcidid>https://orcid.org/0000-0002-7300-6396</orcidid><orcidid>https://orcid.org/0000-0002-7631-4124</orcidid><orcidid>https://orcid.org/0000-0002-1544-577X</orcidid><orcidid>https://orcid.org/0000-0002-5138-3051</orcidid><orcidid>https://orcid.org/0000-0002-7336-1371</orcidid><orcidid>https://orcid.org/0000-0002-3180-3178</orcidid></search><sort><creationdate>20220401</creationdate><title>Radiologic Response as a Prognostic Factor in Advanced Hepatocellular Carcinoma with Macroscopic Vascular Invasion after Transarterial Chemoembolization and Radiotherapy</title><author>Jung, Jinhong ; Joo, Ji Hyeon ; Kim, So Yeon ; Kim, Jin Hyoung ; Choi, Jonggi ; Lee, Danbi ; Shim, Ju Hyun ; Kim, Kang Mo ; Lim, Young-Suk ; Lee, Han Chu ; Park, Jin-hong ; Yoon, Sang Min</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c585t-6be679df3da3c55bd598dd203f38d1e71991d4d76b9b54df01a1a69ebb043ff33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Cancer therapies</topic><topic>Care and treatment</topic><topic>Chemoembolization</topic><topic>Disease</topic><topic>Embolization</topic><topic>Hepatoma</topic><topic>Liver</topic><topic>Liver cancer</topic><topic>Medical prognosis</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Metastasis</topic><topic>Prognosis</topic><topic>Radiation therapy</topic><topic>Radiotherapy</topic><topic>Research Article</topic><topic>Respiration</topic><topic>Response rates</topic><topic>Thrombosis</topic><topic>Tumors</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jung, Jinhong</creatorcontrib><creatorcontrib>Joo, Ji Hyeon</creatorcontrib><creatorcontrib>Kim, So Yeon</creatorcontrib><creatorcontrib>Kim, Jin Hyoung</creatorcontrib><creatorcontrib>Choi, Jonggi</creatorcontrib><creatorcontrib>Lee, Danbi</creatorcontrib><creatorcontrib>Shim, Ju Hyun</creatorcontrib><creatorcontrib>Kim, Kang Mo</creatorcontrib><creatorcontrib>Lim, Young-Suk</creatorcontrib><creatorcontrib>Lee, Han Chu</creatorcontrib><creatorcontrib>Park, Jin-hong</creatorcontrib><creatorcontrib>Yoon, Sang Min</creatorcontrib><collection>Karger Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Liver cancer (Basel )</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jung, Jinhong</au><au>Joo, Ji Hyeon</au><au>Kim, So Yeon</au><au>Kim, Jin Hyoung</au><au>Choi, Jonggi</au><au>Lee, Danbi</au><au>Shim, Ju Hyun</au><au>Kim, Kang Mo</au><au>Lim, Young-Suk</au><au>Lee, Han Chu</au><au>Park, Jin-hong</au><au>Yoon, Sang Min</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Radiologic Response as a Prognostic Factor in Advanced Hepatocellular Carcinoma with Macroscopic Vascular Invasion after Transarterial Chemoembolization and Radiotherapy</atitle><jtitle>Liver cancer (Basel )</jtitle><addtitle>Liver Cancer</addtitle><date>2022-04-01</date><risdate>2022</risdate><volume>11</volume><issue>2</issue><spage>152</spage><epage>161</epage><pages>152-161</pages><issn>2235-1795</issn><eissn>1664-5553</eissn><abstract>Introduction: We evaluated the radiologic response rate of combined transarterial chemoembolization (TACE) plus radiotherapy (RT) in treatment-naïve patients with liver-confined hepatocellular carcinoma (HCC) with macroscopic vascular invasion (MVI) and analyzed its clinical importance in overall survival (OS) outcomes. Methods: Patients who were treated with TACE plus RT as a first-line treatment for HCC with MVI between January 2010 and December 2015 were retrospectively reviewed. Radiologic response was assessed according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) at 2 and 4 months after completion of RT. Landmark analysis at 2 and 4 months, and time-dependent Cox regression analysis using response as a time-dependent covariate were performed for univariable and multivariable analyses. Results: The 2-month landmark analysis included 427 patients, and the 4-month landmark analysis included 355 patients after excluding patients without imaging studies for response evaluation at 4 months. Radiologic responses were observed in 210 (49.2%) patients at 2 months and 181 (51.8%) patients at 4 months. In multivariable analyses, radiologic response was identified as an independent prognosticator for OS at 2 months (median OS: responders, 23.1 months vs. nonresponders, 8.0 months; hazard ratio [HR], 3.194; p < 0.001) and 4 months (median OS: responders, 26.5 months vs. nonresponders, 9.3 months; HR, 4.534; p < 0.001). Conclusion: Radiologic response assessed by mRECIST was a significant prognostic factor for OS in patients with advanced-stage HCC showing MVI treated with combined TACE plus RT.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>35634423</pmid><doi>10.1159/000521227</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-9275-3197</orcidid><orcidid>https://orcid.org/0000-0002-7300-6396</orcidid><orcidid>https://orcid.org/0000-0002-7631-4124</orcidid><orcidid>https://orcid.org/0000-0002-1544-577X</orcidid><orcidid>https://orcid.org/0000-0002-5138-3051</orcidid><orcidid>https://orcid.org/0000-0002-7336-1371</orcidid><orcidid>https://orcid.org/0000-0002-3180-3178</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Cancer therapies Care and treatment Chemoembolization Disease Embolization Hepatoma Liver Liver cancer Medical prognosis Medical research Medicine, Experimental Metastasis Prognosis Radiation therapy Radiotherapy Research Article Respiration Response rates Thrombosis Tumors Veins & arteries |
| title | Radiologic Response as a Prognostic Factor in Advanced Hepatocellular Carcinoma with Macroscopic Vascular Invasion after Transarterial Chemoembolization and Radiotherapy |
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