title: Comparison of the methods for tumor response assessment in patients with hepatocellular carcinoma undergoing transarterial chemoembolization.
abstract: OBJECTIVE
  Recently, new methods, including the concept of viable enhancing tumor such as EASL and mRECIST, have been proposed for substitution of the conventional WHO and RECIST criteria in hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). Herein, we evaluated the differences of four methods and compared the association of these methods with the prognosis of HCC patients undergoing TACE.
  
  
  METHODS
  We retrospectively reviewed 114 consecutive newly diagnosed HCC patients who underwent TACE as initial treatment. We evaluated the intermethod agreement (κ values) between the methods and compared their association with the prognosis of HCC patients.
  
  
  RESULTS
  The κ values for EASL vs. WHO, EASL vs. RECIST, mRECIST vs. WHO, and mRECIST vs. RECIST were low, of 0.102, 0.088, 0.112, and 0.122, respectively. However, good correlations were observed for WHO vs. RECIST and EASL vs. mRECIST (κ=0.883, κ=0.759, respectively p<0.001). The median OS was 32.3 months. Hazard ratios (HR) for survival in responders compared with non-responders were 0.21 (95% CI; 0.12-0.37, p<0.001) for EASL and 0.27 (95% CI; 0.15-0.48, p<0.001) for mRECIST. The mean survival of responders was significantly longer than that of non-responders in both EASL (40.8 vs. 16.9 months, p<0.001) and mRECIST (41.1 vs. 20.7 months, p<0.001). In multivariate analysis, EASL response (HR 0.21, 95% CI 0.11-0.40, p<0.001) and mRECIST response (HR; 0.31, 95% CI, 0.17-0.59, p<0.001) were independently associated with survival.
  
  
  CONCLUSIONS
  The response assessment by EASL and mRECIST could reliably predict the survival of HCC patients undergoing TACE and could be applicable in practice in preference to the conventional WHO and RECIST criteria.
authors: Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
authors: Eun Suk
authors: ES
authors: Jung
authors: Ji Hoon
authors: JH
authors: Kim
authors: Eileen L
authors: EL
authors: Yoon
authors: Hyun Jung
authors: HJ
authors: Lee
authors: Soon Jae
authors: SJ
authors: Lee
authors: Sang Jun
authors: SJ
authors: Suh
authors: Beom Jae
authors: BJ
authors: Lee
authors: Yeon Seok
authors: YS
authors: Seo
authors: Hyung Joon
authors: HJ
authors: Yim
authors: Tae-Seok
authors: TS
authors: Seo
authors: Chang Hee
authors: CH
authors: Lee
authors: Jong Eun
authors: JE
authors: Yeon
authors: Jong-Jae
authors: JJ
authors: Park
authors: Jae Seon
authors: JS
authors: Kim
authors: Young Tae
authors: YT
authors: Bak
authors: Kwan Soo
authors: KS
authors: Byun
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies