Identifying Staging Markers for Hepatocellular Carcinoma before Transarterial Chemoembolization: Comparison of Three-dimensional Quantitative versus Non-three-dimensional Imaging Markers.

Détails

ID Serval
serval:BIB_9AAF31410CA4
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Identifying Staging Markers for Hepatocellular Carcinoma before Transarterial Chemoembolization: Comparison of Three-dimensional Quantitative versus Non-three-dimensional Imaging Markers.
Périodique
Radiology
Auteur(s)
Chapiro J., Duran R., Lin M., Schernthaner R.E., Wang Z., Gorodetski B., Geschwind J.F.
ISSN
1527-1315 (Electronic)
ISSN-L
0033-8419
Statut éditorial
Publié
Date de publication
2015
Peer-reviewed
Oui
Volume
275
Numéro
2
Pages
438-447
Langue
anglais
Notes
Publication types: Comparative Study ; Evaluation Studies ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
Purpose To test and compare the association between radiologic measurements of lesion diameter, volume, and enhancement on baseline magnetic resonance (MR) images with overall survival and tumor response in patients with unresectable hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE). Materials and Methods This HIPAA-compliant retrospective, single-institution analysis was approved by the institutional review board, with waiver of informed consent. It included 79 patients with unresectable HCC who were treated with TACE. Baseline arterial phase contrast material-enhanced (CE) MR imaging was used to measure the overall and enhancing tumor diameters. A segmentation-based three-dimensional quantification of the overall and enhancing tumor volumes was performed in each patient. Numeric cutoff values (5 cm for diameters and 65 cm(3) for volumes) were used to stratify the patient cohort in two groups. Tumor response rates according to Response Evaluation Criteria in Solid Tumors (RECIST), modified RECIST (mRECIST), and European Association for the Study of the Liver (EASL) guidelines were recorded for all groups. Survival was evaluated by using Kaplan-Meier analysis and was compared by using Cox proportional hazard ratios (HRs) after univariate and multivariate analysis. Results Stratification according to overall and enhancing tumor diameters did not result in a significant separation of survival curves (HR, 1.4; 95% confidence interval [CI]: 0.7, 2.5; P = .234; and HR, 1.6; 95% CI: 0.9, 2.8; P = .08, respectively). The stratification according to overall and enhancing tumor volume achieved significance (HR, 1.8; 95% CI: 0.9, 3.4; P = .022; and HR, 1.8; 95% CI: 1.1, 3.1; P = .017, respectively). As for tumor response, higher response rates were observed in smaller lesions compared with larger lesions, when the 5-cm threshold (27% vs 15% for mRECIST and 45% vs 24% for EASL) was used. Conclusion As opposed to anatomic tumor diameter as the most commonly used staging marker, volumetric assessment of lesion size and enhancement on baseline CE MR images is strongly associated with survival of patients with HCC who were treated with TACE.
Mots-clé
Aged, Carcinoma, Hepatocellular/pathology, Carcinoma, Hepatocellular/therapy, Chemoembolization, Therapeutic/methods, Female, Humans, Imaging, Three-Dimensional, Liver Neoplasms/pathology, Liver Neoplasms/therapy, Magnetic Resonance Imaging/methods, Male, Middle Aged, Multivariate Analysis, Neoplasm Staging, Retrospective Studies, Tumor Burden
Pubmed
Création de la notice
03/09/2015 11:17
Dernière modification de la notice
20/08/2019 16:01
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