Optimal time point of response assessment for predicting survival is associated with tumor burden in hepatocellular carcinoma receiving repeated transarterial chemoembolization
Objectives Objective response rate (ORR) under mRECIST criteria after transarterial chemoembolization (TACE) is a well-perceived surrogate endpoint of overall survival (OS). However, its optimal time point remains controversial and may be influenced by tumor burden. We aim to investigate the surroga...
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| Veröffentlicht in: | European radiology 2022-09, Vol.32 (9), p.5799-5810 |
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| creator | Xia, Dongdong Wang, Qiuhe Bai, Wei Wang, Enxin Wang, Zhexuan Mu, Wei Sun, Junhui Huang, Ming Yin, Guowen Li, Hailiang Zhao, Hui Zhang, Chunqing Li, Jing Wu, Jianbing Zhu, Xiaoli Yang, Shufa Pan, Xingnan Li, Jiaping Li, Zixiang Xu, Guohui Shi, Haibin Zhang, Hui Zhang, Yuelin Ding, Rong Yu, Hui Zheng, Lin Yang, Xiaohu Wang, Guangchuan You, Nan Feng, Long Zhang, Shuai Huang, Wukui Xu, Tao Fan, Wenzhe Li, Xueda Yang, Xuegang Zhou, Weizhong Wang, Wenjun Li, Xiaomei Wang, Zhengyu Luo, Bohan Niu, Jing Yuan, Jie Lv, Yong Li, Kai Guo, Wengang Yin, Zhanxin Fan, Daiming Xia, Jielai Han, Guohong |
| description | Objectives
Objective response rate (ORR) under mRECIST criteria after transarterial chemoembolization (TACE) is a well-perceived surrogate endpoint of overall survival (OS). However, its optimal time point remains controversial and may be influenced by tumor burden. We aim to investigate the surrogacy of initial/best ORR in relation to tumor burden.
Methods
A total of 1549 eligible treatment-naïve patients with unresectable hepatocellular carcinoma (HCC), Child-Pugh score ≤ 7, and performance status score ≤ 1 undergoing TACE between January 2010 and May 2016 from 17 academic hospitals were retrospectively analyzed. Based on “six-and-twelve” criteria, tumor burden was graded as low, intermediate, and high if the sum of the maximum tumor diameter and tumor number was ≤ 6, > 6 but ≤ 12, and > 12, respectively.
Results
Both initial and best ORRs interacted with tumor burden. Initial and best ORRs could equivalently predict and correlate with OS in low (adjusted HR, 2.55 and 2.95, respectively, both
p
< 0.001;
R
= 0.84,
p
= 0.035, and
R
= 0.97,
p
= 0.002, respectively) and intermediate strata (adjusted HR, 1.81 and 2.22, respectively, both
p
< 0.001;
R
= 0.74,
p
= 0.023, and
R
= 0.9,
p
= 0.002, respectively). For high strata, only best ORR exhibited qualified surrogacy (adjusted HR, 2.61,
p
< 0.001;
R
= 0.70,
p
= 0.035), whereas initial ORR was not significant (adjusted HR, 1.08,
p
= 0.357;
R
= 0.22,
p
= 0.54).
Conclusions
ORR as surrogacy of OS is associated with tumor burden. For patients with low/intermediate tumor burden, initial ORR should be preferred in its early availability upon similar sensitivity, whereas for patients with high tumor burden, best ORR has optimal sensitivity. Timing of OR assessment should be tailored according to tumor burden.
Key Points
• This is the first study utilizing individual patient data to comprehensively analyze the surrogacy of ORR with a long follow-up period.
• Optimal timing of ORR assessment for predicting survival should be tailored according to tumor burden.
• For patients with low and intermediate tumor burden, initial ORR is optimal for its timeliness upon similar sensitivity with best ORR. For patients with high tumor burden, best ORR has optimal sensitivity. |
| doi_str_mv | 10.1007/s00330-022-08716-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2647654595</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2702664326</sourcerecordid><originalsourceid>FETCH-LOGICAL-c419t-6d1bd6e466d5a64bda24f42996a32741b0d898e2222ba560c0257bffd3f575113</originalsourceid><addsrcrecordid>eNp9kc1u1TAQhSMEoqXwAiyQJTbdBPyfZIkqKEiVuoG15diTXleJHTzOReWpeER8e8uPWOCFPbK_c8b2aZqXjL5hlHZvkVIhaEs5b2nfMd3KR80pk4K3jPby8V_1SfMM8ZZSOjDZPW1OhBI965U4bX5cryUsdiZ1BrKmEAtJE8mAa4oIxCIC4gJ1e0qZrBl8cCXEG4Jb3od9VQY8UMkFW8CTb6HsSNmWCo9b9hBJiGQHqy3JwTxvs83E2exCTIutfRyE_cEuwwr3BiXbiDYXyKGaux0sCZYxzeG7LSHF582Tyc4ILx7Ws-bLh_efLz62V9eXny7eXbVOsqG02rPRa5Bae2W1HL3lcpJ8GLQVvJNspL4feuB1jFZp6ihX3ThNXkyqU4yJs-b86Lvm9HUDLGYJeHiBjZA2NFzLTiupBlXR1_-gt2nLsd7O8I5yrWsMulL8SLmcEDNMZs315_OdYdQc8jTHPE3N09znaWQVvXqw3sYF_G_JrwArII4A1qN4A_lP7__Y_gRJurAR</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2702664326</pqid></control><display><type>article</type><title>Optimal time point of response assessment for predicting survival is associated with tumor burden in hepatocellular carcinoma receiving repeated transarterial chemoembolization</title><source>SpringerLink Journals - AutoHoldings</source><creator>Xia, Dongdong ; Wang, Qiuhe ; Bai, Wei ; Wang, Enxin ; Wang, Zhexuan ; Mu, Wei ; Sun, Junhui ; Huang, Ming ; Yin, Guowen ; Li, Hailiang ; Zhao, Hui ; Zhang, Chunqing ; Li, Jing ; Wu, Jianbing ; Zhu, Xiaoli ; Yang, Shufa ; Pan, Xingnan ; Li, Jiaping ; Li, Zixiang ; Xu, Guohui ; Shi, Haibin ; Zhang, Hui ; Zhang, Yuelin ; Ding, Rong ; Yu, Hui ; Zheng, Lin ; Yang, Xiaohu ; Wang, Guangchuan ; You, Nan ; Feng, Long ; Zhang, Shuai ; Huang, Wukui ; Xu, Tao ; Fan, Wenzhe ; Li, Xueda ; Yang, Xuegang ; Zhou, Weizhong ; Wang, Wenjun ; Li, Xiaomei ; Wang, Zhengyu ; Luo, Bohan ; Niu, Jing ; Yuan, Jie ; Lv, Yong ; Li, Kai ; Guo, Wengang ; Yin, Zhanxin ; Fan, Daiming ; Xia, Jielai ; Han, Guohong</creator><creatorcontrib>Xia, Dongdong ; Wang, Qiuhe ; Bai, Wei ; Wang, Enxin ; Wang, Zhexuan ; Mu, Wei ; Sun, Junhui ; Huang, Ming ; Yin, Guowen ; Li, Hailiang ; Zhao, Hui ; Zhang, Chunqing ; Li, Jing ; Wu, Jianbing ; Zhu, Xiaoli ; Yang, Shufa ; Pan, Xingnan ; Li, Jiaping ; Li, Zixiang ; Xu, Guohui ; Shi, Haibin ; Zhang, Hui ; Zhang, Yuelin ; Ding, Rong ; Yu, Hui ; Zheng, Lin ; Yang, Xiaohu ; Wang, Guangchuan ; You, Nan ; Feng, Long ; Zhang, Shuai ; Huang, Wukui ; Xu, Tao ; Fan, Wenzhe ; Li, Xueda ; Yang, Xuegang ; Zhou, Weizhong ; Wang, Wenjun ; Li, Xiaomei ; Wang, Zhengyu ; Luo, Bohan ; Niu, Jing ; Yuan, Jie ; Lv, Yong ; Li, Kai ; Guo, Wengang ; Yin, Zhanxin ; Fan, Daiming ; Xia, Jielai ; Han, Guohong ; China HCC-TACE Study Group ; on behalf of China HCC-TACE Study Group</creatorcontrib><description>Objectives
Objective response rate (ORR) under mRECIST criteria after transarterial chemoembolization (TACE) is a well-perceived surrogate endpoint of overall survival (OS). However, its optimal time point remains controversial and may be influenced by tumor burden. We aim to investigate the surrogacy of initial/best ORR in relation to tumor burden.
Methods
A total of 1549 eligible treatment-naïve patients with unresectable hepatocellular carcinoma (HCC), Child-Pugh score ≤ 7, and performance status score ≤ 1 undergoing TACE between January 2010 and May 2016 from 17 academic hospitals were retrospectively analyzed. Based on “six-and-twelve” criteria, tumor burden was graded as low, intermediate, and high if the sum of the maximum tumor diameter and tumor number was ≤ 6, > 6 but ≤ 12, and > 12, respectively.
Results
Both initial and best ORRs interacted with tumor burden. Initial and best ORRs could equivalently predict and correlate with OS in low (adjusted HR, 2.55 and 2.95, respectively, both
p
< 0.001;
R
= 0.84,
p
= 0.035, and
R
= 0.97,
p
= 0.002, respectively) and intermediate strata (adjusted HR, 1.81 and 2.22, respectively, both
p
< 0.001;
R
= 0.74,
p
= 0.023, and
R
= 0.9,
p
= 0.002, respectively). For high strata, only best ORR exhibited qualified surrogacy (adjusted HR, 2.61,
p
< 0.001;
R
= 0.70,
p
= 0.035), whereas initial ORR was not significant (adjusted HR, 1.08,
p
= 0.357;
R
= 0.22,
p
= 0.54).
Conclusions
ORR as surrogacy of OS is associated with tumor burden. For patients with low/intermediate tumor burden, initial ORR should be preferred in its early availability upon similar sensitivity, whereas for patients with high tumor burden, best ORR has optimal sensitivity. Timing of OR assessment should be tailored according to tumor burden.
Key Points
• This is the first study utilizing individual patient data to comprehensively analyze the surrogacy of ORR with a long follow-up period.
• Optimal timing of ORR assessment for predicting survival should be tailored according to tumor burden.
• For patients with low and intermediate tumor burden, initial ORR is optimal for its timeliness upon similar sensitivity with best ORR. For patients with high tumor burden, best ORR has optimal sensitivity.</description><identifier>ISSN: 1432-1084</identifier><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-022-08716-4</identifier><identifier>PMID: 35381853</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Chemoembolization ; Criteria ; Diagnostic Radiology ; Embolization ; Hepatocellular carcinoma ; Imaging ; Internal Medicine ; Interventional Radiology ; Liver cancer ; Medicine ; Medicine & Public Health ; Neuroradiology ; Patients ; Radiology ; Sensitivity analysis ; Strata ; Survival ; Survival analysis ; Tumors ; Ultrasound ; Vascular-Interventional</subject><ispartof>European radiology, 2022-09, Vol.32 (9), p.5799-5810</ispartof><rights>The Author(s), under exclusive licence to European Society of Radiology 2022</rights><rights>2022. The Author(s), under exclusive licence to European Society of Radiology.</rights><rights>The Author(s), under exclusive licence to European Society of Radiology 2022.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-6d1bd6e466d5a64bda24f42996a32741b0d898e2222ba560c0257bffd3f575113</citedby><cites>FETCH-LOGICAL-c419t-6d1bd6e466d5a64bda24f42996a32741b0d898e2222ba560c0257bffd3f575113</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-022-08716-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-022-08716-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35381853$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Xia, Dongdong</creatorcontrib><creatorcontrib>Wang, Qiuhe</creatorcontrib><creatorcontrib>Bai, Wei</creatorcontrib><creatorcontrib>Wang, Enxin</creatorcontrib><creatorcontrib>Wang, Zhexuan</creatorcontrib><creatorcontrib>Mu, Wei</creatorcontrib><creatorcontrib>Sun, Junhui</creatorcontrib><creatorcontrib>Huang, Ming</creatorcontrib><creatorcontrib>Yin, Guowen</creatorcontrib><creatorcontrib>Li, Hailiang</creatorcontrib><creatorcontrib>Zhao, Hui</creatorcontrib><creatorcontrib>Zhang, Chunqing</creatorcontrib><creatorcontrib>Li, Jing</creatorcontrib><creatorcontrib>Wu, Jianbing</creatorcontrib><creatorcontrib>Zhu, Xiaoli</creatorcontrib><creatorcontrib>Yang, Shufa</creatorcontrib><creatorcontrib>Pan, Xingnan</creatorcontrib><creatorcontrib>Li, Jiaping</creatorcontrib><creatorcontrib>Li, Zixiang</creatorcontrib><creatorcontrib>Xu, Guohui</creatorcontrib><creatorcontrib>Shi, Haibin</creatorcontrib><creatorcontrib>Zhang, Hui</creatorcontrib><creatorcontrib>Zhang, Yuelin</creatorcontrib><creatorcontrib>Ding, Rong</creatorcontrib><creatorcontrib>Yu, Hui</creatorcontrib><creatorcontrib>Zheng, Lin</creatorcontrib><creatorcontrib>Yang, Xiaohu</creatorcontrib><creatorcontrib>Wang, Guangchuan</creatorcontrib><creatorcontrib>You, Nan</creatorcontrib><creatorcontrib>Feng, Long</creatorcontrib><creatorcontrib>Zhang, Shuai</creatorcontrib><creatorcontrib>Huang, Wukui</creatorcontrib><creatorcontrib>Xu, Tao</creatorcontrib><creatorcontrib>Fan, Wenzhe</creatorcontrib><creatorcontrib>Li, Xueda</creatorcontrib><creatorcontrib>Yang, Xuegang</creatorcontrib><creatorcontrib>Zhou, Weizhong</creatorcontrib><creatorcontrib>Wang, Wenjun</creatorcontrib><creatorcontrib>Li, Xiaomei</creatorcontrib><creatorcontrib>Wang, Zhengyu</creatorcontrib><creatorcontrib>Luo, Bohan</creatorcontrib><creatorcontrib>Niu, Jing</creatorcontrib><creatorcontrib>Yuan, Jie</creatorcontrib><creatorcontrib>Lv, Yong</creatorcontrib><creatorcontrib>Li, Kai</creatorcontrib><creatorcontrib>Guo, Wengang</creatorcontrib><creatorcontrib>Yin, Zhanxin</creatorcontrib><creatorcontrib>Fan, Daiming</creatorcontrib><creatorcontrib>Xia, Jielai</creatorcontrib><creatorcontrib>Han, Guohong</creatorcontrib><creatorcontrib>China HCC-TACE Study Group</creatorcontrib><creatorcontrib>on behalf of China HCC-TACE Study Group</creatorcontrib><title>Optimal time point of response assessment for predicting survival is associated with tumor burden in hepatocellular carcinoma receiving repeated transarterial chemoembolization</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>Objectives
Objective response rate (ORR) under mRECIST criteria after transarterial chemoembolization (TACE) is a well-perceived surrogate endpoint of overall survival (OS). However, its optimal time point remains controversial and may be influenced by tumor burden. We aim to investigate the surrogacy of initial/best ORR in relation to tumor burden.
Methods
A total of 1549 eligible treatment-naïve patients with unresectable hepatocellular carcinoma (HCC), Child-Pugh score ≤ 7, and performance status score ≤ 1 undergoing TACE between January 2010 and May 2016 from 17 academic hospitals were retrospectively analyzed. Based on “six-and-twelve” criteria, tumor burden was graded as low, intermediate, and high if the sum of the maximum tumor diameter and tumor number was ≤ 6, > 6 but ≤ 12, and > 12, respectively.
Results
Both initial and best ORRs interacted with tumor burden. Initial and best ORRs could equivalently predict and correlate with OS in low (adjusted HR, 2.55 and 2.95, respectively, both
p
< 0.001;
R
= 0.84,
p
= 0.035, and
R
= 0.97,
p
= 0.002, respectively) and intermediate strata (adjusted HR, 1.81 and 2.22, respectively, both
p
< 0.001;
R
= 0.74,
p
= 0.023, and
R
= 0.9,
p
= 0.002, respectively). For high strata, only best ORR exhibited qualified surrogacy (adjusted HR, 2.61,
p
< 0.001;
R
= 0.70,
p
= 0.035), whereas initial ORR was not significant (adjusted HR, 1.08,
p
= 0.357;
R
= 0.22,
p
= 0.54).
Conclusions
ORR as surrogacy of OS is associated with tumor burden. For patients with low/intermediate tumor burden, initial ORR should be preferred in its early availability upon similar sensitivity, whereas for patients with high tumor burden, best ORR has optimal sensitivity. Timing of OR assessment should be tailored according to tumor burden.
Key Points
• This is the first study utilizing individual patient data to comprehensively analyze the surrogacy of ORR with a long follow-up period.
• Optimal timing of ORR assessment for predicting survival should be tailored according to tumor burden.
• For patients with low and intermediate tumor burden, initial ORR is optimal for its timeliness upon similar sensitivity with best ORR. For patients with high tumor burden, best ORR has optimal sensitivity.</description><subject>Chemoembolization</subject><subject>Criteria</subject><subject>Diagnostic Radiology</subject><subject>Embolization</subject><subject>Hepatocellular carcinoma</subject><subject>Imaging</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Liver cancer</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neuroradiology</subject><subject>Patients</subject><subject>Radiology</subject><subject>Sensitivity analysis</subject><subject>Strata</subject><subject>Survival</subject><subject>Survival analysis</subject><subject>Tumors</subject><subject>Ultrasound</subject><subject>Vascular-Interventional</subject><issn>1432-1084</issn><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kc1u1TAQhSMEoqXwAiyQJTbdBPyfZIkqKEiVuoG15diTXleJHTzOReWpeER8e8uPWOCFPbK_c8b2aZqXjL5hlHZvkVIhaEs5b2nfMd3KR80pk4K3jPby8V_1SfMM8ZZSOjDZPW1OhBI965U4bX5cryUsdiZ1BrKmEAtJE8mAa4oIxCIC4gJ1e0qZrBl8cCXEG4Jb3od9VQY8UMkFW8CTb6HsSNmWCo9b9hBJiGQHqy3JwTxvs83E2exCTIutfRyE_cEuwwr3BiXbiDYXyKGaux0sCZYxzeG7LSHF582Tyc4ILx7Ws-bLh_efLz62V9eXny7eXbVOsqG02rPRa5Bae2W1HL3lcpJ8GLQVvJNspL4feuB1jFZp6ihX3ThNXkyqU4yJs-b86Lvm9HUDLGYJeHiBjZA2NFzLTiupBlXR1_-gt2nLsd7O8I5yrWsMulL8SLmcEDNMZs315_OdYdQc8jTHPE3N09znaWQVvXqw3sYF_G_JrwArII4A1qN4A_lP7__Y_gRJurAR</recordid><startdate>20220901</startdate><enddate>20220901</enddate><creator>Xia, Dongdong</creator><creator>Wang, Qiuhe</creator><creator>Bai, Wei</creator><creator>Wang, Enxin</creator><creator>Wang, Zhexuan</creator><creator>Mu, Wei</creator><creator>Sun, Junhui</creator><creator>Huang, Ming</creator><creator>Yin, Guowen</creator><creator>Li, Hailiang</creator><creator>Zhao, Hui</creator><creator>Zhang, Chunqing</creator><creator>Li, Jing</creator><creator>Wu, Jianbing</creator><creator>Zhu, Xiaoli</creator><creator>Yang, Shufa</creator><creator>Pan, Xingnan</creator><creator>Li, Jiaping</creator><creator>Li, Zixiang</creator><creator>Xu, Guohui</creator><creator>Shi, Haibin</creator><creator>Zhang, Hui</creator><creator>Zhang, Yuelin</creator><creator>Ding, Rong</creator><creator>Yu, Hui</creator><creator>Zheng, Lin</creator><creator>Yang, Xiaohu</creator><creator>Wang, Guangchuan</creator><creator>You, Nan</creator><creator>Feng, Long</creator><creator>Zhang, Shuai</creator><creator>Huang, Wukui</creator><creator>Xu, Tao</creator><creator>Fan, Wenzhe</creator><creator>Li, Xueda</creator><creator>Yang, Xuegang</creator><creator>Zhou, Weizhong</creator><creator>Wang, Wenjun</creator><creator>Li, Xiaomei</creator><creator>Wang, Zhengyu</creator><creator>Luo, Bohan</creator><creator>Niu, Jing</creator><creator>Yuan, Jie</creator><creator>Lv, Yong</creator><creator>Li, Kai</creator><creator>Guo, Wengang</creator><creator>Yin, Zhanxin</creator><creator>Fan, Daiming</creator><creator>Xia, Jielai</creator><creator>Han, Guohong</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20220901</creationdate><title>Optimal time point of response assessment for predicting survival is associated with tumor burden in hepatocellular carcinoma receiving repeated transarterial chemoembolization</title><author>Xia, Dongdong ; Wang, Qiuhe ; Bai, Wei ; Wang, Enxin ; Wang, Zhexuan ; Mu, Wei ; Sun, Junhui ; Huang, Ming ; Yin, Guowen ; Li, Hailiang ; Zhao, Hui ; Zhang, Chunqing ; Li, Jing ; Wu, Jianbing ; Zhu, Xiaoli ; Yang, Shufa ; Pan, Xingnan ; Li, Jiaping ; Li, Zixiang ; Xu, Guohui ; Shi, Haibin ; Zhang, Hui ; Zhang, Yuelin ; Ding, Rong ; Yu, Hui ; Zheng, Lin ; Yang, Xiaohu ; Wang, Guangchuan ; You, Nan ; Feng, Long ; Zhang, Shuai ; Huang, Wukui ; Xu, Tao ; Fan, Wenzhe ; Li, Xueda ; Yang, Xuegang ; Zhou, Weizhong ; Wang, Wenjun ; Li, Xiaomei ; Wang, Zhengyu ; Luo, Bohan ; Niu, Jing ; Yuan, Jie ; Lv, Yong ; Li, Kai ; Guo, Wengang ; Yin, Zhanxin ; Fan, Daiming ; Xia, Jielai ; Han, Guohong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c419t-6d1bd6e466d5a64bda24f42996a32741b0d898e2222ba560c0257bffd3f575113</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Chemoembolization</topic><topic>Criteria</topic><topic>Diagnostic Radiology</topic><topic>Embolization</topic><topic>Hepatocellular carcinoma</topic><topic>Imaging</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Liver cancer</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neuroradiology</topic><topic>Patients</topic><topic>Radiology</topic><topic>Sensitivity analysis</topic><topic>Strata</topic><topic>Survival</topic><topic>Survival analysis</topic><topic>Tumors</topic><topic>Ultrasound</topic><topic>Vascular-Interventional</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Xia, Dongdong</creatorcontrib><creatorcontrib>Wang, Qiuhe</creatorcontrib><creatorcontrib>Bai, Wei</creatorcontrib><creatorcontrib>Wang, Enxin</creatorcontrib><creatorcontrib>Wang, Zhexuan</creatorcontrib><creatorcontrib>Mu, Wei</creatorcontrib><creatorcontrib>Sun, Junhui</creatorcontrib><creatorcontrib>Huang, Ming</creatorcontrib><creatorcontrib>Yin, Guowen</creatorcontrib><creatorcontrib>Li, Hailiang</creatorcontrib><creatorcontrib>Zhao, Hui</creatorcontrib><creatorcontrib>Zhang, Chunqing</creatorcontrib><creatorcontrib>Li, Jing</creatorcontrib><creatorcontrib>Wu, Jianbing</creatorcontrib><creatorcontrib>Zhu, Xiaoli</creatorcontrib><creatorcontrib>Yang, Shufa</creatorcontrib><creatorcontrib>Pan, Xingnan</creatorcontrib><creatorcontrib>Li, Jiaping</creatorcontrib><creatorcontrib>Li, Zixiang</creatorcontrib><creatorcontrib>Xu, Guohui</creatorcontrib><creatorcontrib>Shi, Haibin</creatorcontrib><creatorcontrib>Zhang, Hui</creatorcontrib><creatorcontrib>Zhang, Yuelin</creatorcontrib><creatorcontrib>Ding, Rong</creatorcontrib><creatorcontrib>Yu, Hui</creatorcontrib><creatorcontrib>Zheng, Lin</creatorcontrib><creatorcontrib>Yang, Xiaohu</creatorcontrib><creatorcontrib>Wang, Guangchuan</creatorcontrib><creatorcontrib>You, Nan</creatorcontrib><creatorcontrib>Feng, Long</creatorcontrib><creatorcontrib>Zhang, Shuai</creatorcontrib><creatorcontrib>Huang, Wukui</creatorcontrib><creatorcontrib>Xu, Tao</creatorcontrib><creatorcontrib>Fan, Wenzhe</creatorcontrib><creatorcontrib>Li, Xueda</creatorcontrib><creatorcontrib>Yang, Xuegang</creatorcontrib><creatorcontrib>Zhou, Weizhong</creatorcontrib><creatorcontrib>Wang, Wenjun</creatorcontrib><creatorcontrib>Li, Xiaomei</creatorcontrib><creatorcontrib>Wang, Zhengyu</creatorcontrib><creatorcontrib>Luo, Bohan</creatorcontrib><creatorcontrib>Niu, Jing</creatorcontrib><creatorcontrib>Yuan, Jie</creatorcontrib><creatorcontrib>Lv, Yong</creatorcontrib><creatorcontrib>Li, Kai</creatorcontrib><creatorcontrib>Guo, Wengang</creatorcontrib><creatorcontrib>Yin, Zhanxin</creatorcontrib><creatorcontrib>Fan, Daiming</creatorcontrib><creatorcontrib>Xia, Jielai</creatorcontrib><creatorcontrib>Han, Guohong</creatorcontrib><creatorcontrib>China HCC-TACE Study Group</creatorcontrib><creatorcontrib>on behalf of China HCC-TACE Study Group</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</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>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection (ProQuest)</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Xia, Dongdong</au><au>Wang, Qiuhe</au><au>Bai, Wei</au><au>Wang, Enxin</au><au>Wang, Zhexuan</au><au>Mu, Wei</au><au>Sun, Junhui</au><au>Huang, Ming</au><au>Yin, Guowen</au><au>Li, Hailiang</au><au>Zhao, Hui</au><au>Zhang, Chunqing</au><au>Li, Jing</au><au>Wu, Jianbing</au><au>Zhu, Xiaoli</au><au>Yang, Shufa</au><au>Pan, Xingnan</au><au>Li, Jiaping</au><au>Li, Zixiang</au><au>Xu, Guohui</au><au>Shi, Haibin</au><au>Zhang, Hui</au><au>Zhang, Yuelin</au><au>Ding, Rong</au><au>Yu, Hui</au><au>Zheng, Lin</au><au>Yang, Xiaohu</au><au>Wang, Guangchuan</au><au>You, Nan</au><au>Feng, Long</au><au>Zhang, Shuai</au><au>Huang, Wukui</au><au>Xu, Tao</au><au>Fan, Wenzhe</au><au>Li, Xueda</au><au>Yang, Xuegang</au><au>Zhou, Weizhong</au><au>Wang, Wenjun</au><au>Li, Xiaomei</au><au>Wang, Zhengyu</au><au>Luo, Bohan</au><au>Niu, Jing</au><au>Yuan, Jie</au><au>Lv, Yong</au><au>Li, Kai</au><au>Guo, Wengang</au><au>Yin, Zhanxin</au><au>Fan, Daiming</au><au>Xia, Jielai</au><au>Han, Guohong</au><aucorp>China HCC-TACE Study Group</aucorp><aucorp>on behalf of China HCC-TACE Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Optimal time point of response assessment for predicting survival is associated with tumor burden in hepatocellular carcinoma receiving repeated transarterial chemoembolization</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2022-09-01</date><risdate>2022</risdate><volume>32</volume><issue>9</issue><spage>5799</spage><epage>5810</epage><pages>5799-5810</pages><issn>1432-1084</issn><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>Objectives
Objective response rate (ORR) under mRECIST criteria after transarterial chemoembolization (TACE) is a well-perceived surrogate endpoint of overall survival (OS). However, its optimal time point remains controversial and may be influenced by tumor burden. We aim to investigate the surrogacy of initial/best ORR in relation to tumor burden.
Methods
A total of 1549 eligible treatment-naïve patients with unresectable hepatocellular carcinoma (HCC), Child-Pugh score ≤ 7, and performance status score ≤ 1 undergoing TACE between January 2010 and May 2016 from 17 academic hospitals were retrospectively analyzed. Based on “six-and-twelve” criteria, tumor burden was graded as low, intermediate, and high if the sum of the maximum tumor diameter and tumor number was ≤ 6, > 6 but ≤ 12, and > 12, respectively.
Results
Both initial and best ORRs interacted with tumor burden. Initial and best ORRs could equivalently predict and correlate with OS in low (adjusted HR, 2.55 and 2.95, respectively, both
p
< 0.001;
R
= 0.84,
p
= 0.035, and
R
= 0.97,
p
= 0.002, respectively) and intermediate strata (adjusted HR, 1.81 and 2.22, respectively, both
p
< 0.001;
R
= 0.74,
p
= 0.023, and
R
= 0.9,
p
= 0.002, respectively). For high strata, only best ORR exhibited qualified surrogacy (adjusted HR, 2.61,
p
< 0.001;
R
= 0.70,
p
= 0.035), whereas initial ORR was not significant (adjusted HR, 1.08,
p
= 0.357;
R
= 0.22,
p
= 0.54).
Conclusions
ORR as surrogacy of OS is associated with tumor burden. For patients with low/intermediate tumor burden, initial ORR should be preferred in its early availability upon similar sensitivity, whereas for patients with high tumor burden, best ORR has optimal sensitivity. Timing of OR assessment should be tailored according to tumor burden.
Key Points
• This is the first study utilizing individual patient data to comprehensively analyze the surrogacy of ORR with a long follow-up period.
• Optimal timing of ORR assessment for predicting survival should be tailored according to tumor burden.
• For patients with low and intermediate tumor burden, initial ORR is optimal for its timeliness upon similar sensitivity with best ORR. For patients with high tumor burden, best ORR has optimal sensitivity.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>35381853</pmid><doi>10.1007/s00330-022-08716-4</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1432-1084 |
| ispartof | European radiology, 2022-09, Vol.32 (9), p.5799-5810 |
| issn | 1432-1084 0938-7994 1432-1084 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2647654595 |
| source | SpringerLink Journals - AutoHoldings |
| subjects | Chemoembolization Criteria Diagnostic Radiology Embolization Hepatocellular carcinoma Imaging Internal Medicine Interventional Radiology Liver cancer Medicine Medicine & Public Health Neuroradiology Patients Radiology Sensitivity analysis Strata Survival Survival analysis Tumors Ultrasound Vascular-Interventional |
| title | Optimal time point of response assessment for predicting survival is associated with tumor burden in hepatocellular carcinoma receiving repeated transarterial chemoembolization |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-07T08%3A32%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Optimal%20time%20point%20of%20response%20assessment%20for%20predicting%20survival%20is%20associated%20with%20tumor%20burden%20in%20hepatocellular%20carcinoma%20receiving%20repeated%20transarterial%20chemoembolization&rft.jtitle=European%20radiology&rft.au=Xia,%20Dongdong&rft.aucorp=China%20HCC-TACE%20Study%20Group&rft.date=2022-09-01&rft.volume=32&rft.issue=9&rft.spage=5799&rft.epage=5810&rft.pages=5799-5810&rft.issn=1432-1084&rft.eissn=1432-1084&rft_id=info:doi/10.1007/s00330-022-08716-4&rft_dat=%3Cproquest_cross%3E2702664326%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2702664326&rft_id=info:pmid/35381853&rfr_iscdi=true |