title: m-RECIST at 1 month and Child A are survival predictors after percutaneous ethanol injection of hepatocellular carcinoma.
abstract: OBJECTIVE
  Percutaneous ethanol injection (PEI) is a well-established therapeutic option in patients with cirrhosis and hepatocellular carcinoma (HCC). The modified-Response Evaluation Criteria in Solid Tumors (m-RECIST) are an important tool for the assessment of HCC response to therapy. The aim was to evaluate whether HCC response according to the m-RECIST criteria could be an effective predictor of long-term survival in Barcelona Clinic Liver Cancer (BCLC) stage 0 and A HCC patients undergoing PEI.
  
  
  METHODS
  79 patients were followed-up for median time of 26.8 months. HCC diagnosis was based on the current guidelines of the American Association for Study of the Liver Diseases (AASLD) and European Association for Study of the Liver (EASL). Patient survival was calculated from the first PEI session to the end of the follow-up.
  
  
  RESULTS
  The 1-, 3-, and 5-year overall survival rates were 79, 48 and 37%, respectively. In the multivariate analysis, Child-Pugh-Turcotte (CPT) (p = 0.022) and the response to m-RECIST criteria (p = 0.016) were associated with patient survival. CPT A patients who achieved Complete Response (CR) 1 month after PEI presented a 5-year survival rate of 55%. By contrast, the worst scenario, the group with CPT B but without CR had a 5-year survival rate of 9%, while the group with either CPT A or CR as a survival predictor had a 5-year survival rate of 31%. In conclusion, in BCLC stage 0 and A HCC-patients, m-RECIST at 1 month and Child A may predict survival rates after PEI.
authors.affiliation: Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Mauricio F
authors.initials: MF
authors.lastname: Silva
authors.affiliation: São Paulo Clínicas Liver Cancer Group.
authors.forename: Flair J
authors.initials: FJ
authors.lastname: Carrilho
authors.affiliation: Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Denise C
authors.initials: DC
authors.lastname: Paranaguá-Vezozzo
authors.affiliation: Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Luciana T
authors.initials: LT
authors.lastname: Campos
authors.affiliation: Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Lucas S
authors.initials: LS
authors.lastname: Nacif
authors.affiliation: Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Marcio A
authors.initials: MA
authors.lastname: Diniz
authors.affiliation: Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Alberto Q
authors.initials: AQ
authors.lastname: Farias
authors.affiliation: Department of Pathology, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Venancio A F
authors.initials: VA
authors.lastname: Alves
authors.affiliation: Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Luis A C
authors.initials: LA
authors.lastname: D'Alburquerque
authors.affiliation: Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Suzane K
authors.initials: SK
authors.lastname: Ono
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000145:classification / Q000188:drug therapy* / Q000473:pathology; D015331:Cohort Studies; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D008107:Liver Diseases / Q000145:classification; D008113:Liver Neoplasms / Q000145:classification / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000188:drug therapy* / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012997:Solvents / Q000627:therapeutic use*; D015996:Survival Rate; D016896:Treatment Outcome; D047368:Tumor Burden
chemical_list: D012997:Solvents; D000431:Ethanol