Number of Target Lesions for EASL and Modified RECIST to Predict Survivals in Hepatocellular Carcinoma Treated with Chemoembolization
Number of Target Lesions for EASL and Modified RECIST to Predict Survivals in Hepatocellular Carcinoma Treated with Chemoembolization
复制标题
DOI：
10.1158/1078-0432.ccr-12-2721
复制
发表时间：
2013-03-15
影响因子：
11.5
通讯作者：
Chon, Chae Yoon
中科院分区：
文献类型：
--
作者：
Kim, Beom Kyung;Kim, Seung Up;Chon, Chae Yoon
目的：迄今为止，大多数关于肝细胞癌（HCC）增强标准的最佳靶病灶数量的研究都集中在一致性的横断面分析上。我们研究了欧洲肝脏研究协会（EASL）和改良的实体瘤疗效评价标准（mRECIST）指南在预测总生存期（OS）方面的最佳靶病变数量：我们分析了254例连续治疗初治的HCC患者，这些患者至少有2个可测量的靶病变接受经动脉化疗栓塞。计算方法间治疗反应一致性的Kappa值，以比较使用最多1、2、3、4或5个靶病灶与使用所有靶病灶之间的差异。根据靶病变数量预测OS的放射学评估的预后值表示为C指数。根据EASL和mRECIST指南，评估最长的2、3、4或5个目标和评估所有目标的应答之间的kappa值分别为0.924、0.977、1.000或1.000和0.907、0.959、1.000，或1.000，而仅评估一个靶病灶和评估所有靶病灶的反应之间的差异分别为0.723和0.666。测量最长1、2、3、4、5和所有目标时的C指数相似，EASL标准的范围为0.739 - 0.749，mRECIST的范围为0.750 - 0.759。从考克斯回归分析，从每种计算方法的放射学反应显示独立的显着影响OS的两个指南，无论靶病变的数量。结论：预测OS的预后值是相似的，无论靶病变的数量。考虑到横断面分析的高度一致性，建议评估2个最大的靶病变，而不是仅评估1个索引病变。临床癌症研究; 19（6）; 1503-11。(C)2012年AACR。
Purposes: To date, most studies about the optimal number of target lesions for enhancement criteria for hepatocellular carcinoma (HCC) have focused on cross-sectional analyses of concordance. We investigated the optimal number of target lesions for European Association for the Study of the Liver (EASL) and modified Response Evaluation Criteria in Solid Tumors (mRECIST) guidelines in predicting overall survival (OS).Experimental Design: We analyzed 254 consecutive treatment-naive patients with HCC having at least 2 measurable target lesions undergoing transarterial chemoembolization. Kappa values for intermethod agreement of treatment responses were calculated for comparisons between use of maximum of 1, 2, 3, 4, or 5 targets versus use of all target lesions. Prognostic values of radiologic assessments according to number of target lesions for predicting OS were expressed as C-index.Results: By EASL and mRECIST guidelines, kappa values between responses assessing the longest 2, 3, 4, or 5 targets and assessing all targets were 0.924, 0.977, 1.000, or 1.000 and 0.907, 0.959, 1.000, or 1.000, respectively, whereas those between responses assessing only one target and assessing all target lesions were 0.723 and 0.666, respectively. C-index when measuring the longest 1, 2, 3, 4, 5, and all targets was similar, ranging from 0.739 to 0.749 for EASL criteria and from 0.750 to 0.759 for mRECIST. From Cox regression analyses, radiologic response from each calculation method showed independently significant effects on OS for both guidelines, regardless of number of target lesions.Conclusions: Prognostic values for predicting OS were similar regardless of number of target lesions. Assessing the 2 largest targets rather than only 1 index lesion could be recommended considering high concordances from cross-sectional analyses. Clin Cancer Res; 19(6); 1503-11. (C) 2012 AACR.