Radioembolization for hepatocellular carcinoma: Statistical confirmation of improved survival in responders by landmark analyses
Radioembolization for hepatocellular carcinoma: Statistical confirmation of improved survival in responders by landmark analyses
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DOI：
10.1002/hep.29480
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发表时间：
2018-03-01
期刊：
影响因子：
13.5
通讯作者：
Salem, Riad
中科院分区：
文献类型：
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作者：
Riaz, Ahsun;Gabr, Ahmed;Salem, Riad
影像学反应能否预测肝细胞癌（HCC）的生存率？我们研究了治疗后影像学反应预测总生存率的能力。14年来，948例HCC患者接受了放射性栓塞治疗。排除了基线转移、血管浸润、多灶性疾病、Child-Pugh>B7和移植/切除的患者。这创建了我们的134例Child-PughB 7和孤立性HCC患者的同质研究队列。在审查960次扫描后，使用Landmark和死亡风险方法，将缓解（使用欧洲肝脏研究协会[EASL]和实体瘤缓解评价标准1.1 [RECIST 1.1]标准）与生存率相关。在亚组分析中，将缓解者的生存时间与疾病稳定（SD）和疾病进展（PD）患者的生存时间进行比较。在每个Landmark进行单因素/多因素生存分析。在3个月里程碑时，根据EASL（风险比[HR]，0.46;置信区间[CI]，0.26-0.82; P=0.002），但不是RECIST 1.1标准（HR，0.70; CI，0.37-1.32; P=0.32），应答者的生存时间长于无应答者。在6个月的里程碑，根据EASL，应答者的生存时间长于无应答者（HR，0.32; CI，0.15-0.77; P
Does imaging response predict survival in hepatocellular carcinoma (HCC)? We studied the ability of posttherapeutic imaging response to predict overall survival. Over 14 years, 948 patients with HCC were treated with radioembolization. Patients with baseline metastases, vascular invasion, multifocal disease, Child-Pugh>B7, and transplanted/resected were excluded. This created our homogeneous study cohort of 134 patients with Child-PughB7 and solitary HCC. Response (using European Association for Study of the Liver [EASL] and Response Evaluation Criteria in Solid Tumors 1.1 [RECIST 1.1] criteria) was associated with survival using Landmark and risk-of-death methodologies after reviewing 960 scans. In a subanalysis, survival times of responders were compared to those of patients with stable disease (SD) and progressive disease (PD). Uni/multivariate survival analyses were performed at each Landmark. At the 3-month Landmark, responders survived longer than nonresponders by EASL (hazard ratio [HR], 0.46; confidence interval [CI], 0.26-0.82; P=0.002) but not RECIST 1.1 criteria (HR, 0.70; CI, 0.37-1.32; P=0.32). At the 6-month Landmark, responders survived longer than nonresponders by EASL (HR, 0.32; CI, 0.15-0.77; P