Imaging response in the primary index lesion and clinical outcomes following transarterial locoregional therapy for hepatocellular carcinoma.
Imaging response in the primary index lesion and clinical outcomes following transarterial locoregional therapy for hepatocellular carcinoma.
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DOI：
10.1001/jama.2010.262
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发表时间：
2010-03-17
影响因子：
120.7
通讯作者：
Salem, Riad
中科院分区：
文献类型：
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作者：
Riaz, Ahsun;Miller, Frank H.;Kulik, Laura M.;Nikolaidis, Paul;Yaghmai, Vahid;Lewandowski, Robert J.;Mulcahy, Mary F.;Ryu, Robert K.;Sato, Kent T.;Gupta, Ramona;Wang, Ed;Baker, Talia;Abecassis, Michael;Benson, Al B., III;Nemcek, Albert A., Jr.;Omary, Reed;Salem, Riad
实体瘤疗效评价标准[RECIST（一维）]、世界卫生组织[WHO（二维）]和欧洲肝脏研究协会[EASL（坏死）]指南通常用于评估肝细胞癌（HCC）治疗后的疗效。没有普遍接受的标准。评价这3种成像指南之间的方法间一致性，并引入“原发性索引病变”的概念作为缓解的生物标志物。单中心综合影像学分析。2000年1月至2008年12月期间接受化疗栓塞或放射栓塞治疗的245例连续HCC患者。审查了计算机断层扫描和磁共振成像扫描（N=1065），以评估“原发性索引病变”（定义为首次治疗期间靶向的最大肿瘤）的缓解。RECIST、WHO和EASL指南缓解之间的方法间一致性（k统计量）; WHO和EASL在原发性索引病变中的缓解与至进展时间和生存期的相关性。WHO与RECIST指南之间的κ系数为0.86（95%CI，0.80 -0.92），RECIST与EASL之间的κ系数为0.24（95%CI，0.16-0.33），WHO与EASL之间的κ系数为0.28（95%CI，0.19-0.36）。96例患者病情进展; 113例死亡。WHO、RECIST和EASL中应答者与非应答者相比，至进展时间的风险比分别为0.36（95% CI，0.23-0.57）、0.38（95% CI，0.24-0.58）和0.38（95% CI，0.22-0.64）。在单变量和多变量分析中，应答者与非应答者相比的生存风险比分别为0.46（95% CI，0.32-0.67）和0.55（95% CI，0.35-0.84）; EASL分别为0.36（95% CI，0.22-0.57）和0.54（95% CI，0.34-0.85）。WHO和EASL的孤立性和多灶性HCC患者中，应答者与无应答者的生存风险比分别为0.39（95%CI，0.19-0.77）和0.51（95%CI，0.32-0.82），0.26（95%CI，0.10-0.67）和0.47（95%CI，0.28-0.79）。在一组HCC患者中，RECIST和WHO之间治疗反应分类的一致性较高，但与EASL之间的一致性较低。应用这些方法测量原发性指标病变的缓解与疾病进展和生存率之间的相关性具有统计学意义。
Response Evaluation Criteria in Solid Tumors [RECIST (unidimensional)], World Health Organization [WHO (bi-dimensional)] and European Association for Study of the Liver [EASL (necrosis)] guidelines are commonly used to assess response following therapy for hepatocellular carcinoma (HCC). No universally accepted standard exists. To evaluate intermethod agreement between these 3 imaging guidelines and to introduce the concept of the “primary index lesion” as a biomarker for response. Single-center comprehensive imaging analysis. 245 consecutive patients with HCC who were treated with chemoembolization or radioembolization between January 2000 and December 2008. Computed tomography and magnetic resonance imaging scans (N=1065) were reviewed to assess response in the “primary index lesion,” defined as the largest tumor targeted during first treatment. Intermethod agreement (k statistics) between RECIST, WHO, and EASL guidelines response; correlation of WHO and EASL response in the primary index lesion with time to progression and survival. κ coefficients were 0.86(95% confidence interval [CI],0.80–0.92) between the WHO and RECIST guidelines, 0.24(95% CI, 0.16–0.33) between RECIST and EASL and 0.28 (95% CI, 0.19–0.36) between WHO and EASL. Disease progressed in 96 patients; 113 died. The hazard ratio for time to progression in responders compared with nonresponders was 0.36(95% CI, 0.23–0.57) for WHO, 0.38(95% CI, 0.24–0.58) for RECIST, and 0.38(95% CI, 0.22–0.64) for EASL. Hazard ratios for survival in responders compared with nonresponders in univariate and multivariate analyses were 0.46(95% CI, 0.32–0.67) and 0.55(95% CI, 0.35–0.84); they were 0.36(95% CI, 0.22–0.57) and 0.54(95% CI, 0.34–0.85) for EASL. Hazard ratios for survival in responders vs nonresponders in patients with solitary and multifocal HCC were 0.39 (95% CI, 0.19–0.77) and 0.51 (95% CI, 0.32–0.82) for WHO and 0.26 (95% CI, 0.10–0.67) and 0.47 (95% CI, 0.28–0.79) for EASL. Among a group of patients with HCC, agreement for classification of therapeutic response was high between RECIST and WHO, but low between each of these and EASL. Application of these methods to measure response in a primary index lesion resulted in statistically significant correlations with disease progression and survival.
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影响因子：
8.4
作者：
Eisenhauer, E. A.;Therasse, P.;Verweij, J.
通讯作者：
Verweij, J.
影响因子：
158.5
作者：
Llovet, Josep M.;Ricci, Sergio;Bruix, Jordi
通讯作者：
Bruix, Jordi
影响因子：
4.6
作者：
Maddala, YK;Stadheim, L;Gores, G
通讯作者：
Gores, G
影响因子：
19.7
作者：
Lu, DSK;Yu, NC;Busuttil, RW
通讯作者：
Busuttil, RW
DOI：
10.1002/lt.20034
发表时间：
2004-02-01
期刊：
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
影响因子：
--
作者：
Llovet, Josep M;Fuster, Josep;Bruix, Jordi
通讯作者：
Bruix, Jordi