title: Initial response to sorafenib by using enhancement criteria in patients with hepatocellular carcinoma.
abstract: OBJECTIVE
  Sorafenib induces early vascularity reduction in patients with hepatocellular carcinoma (HCC). We sought to identify differences in radiological assessment approaches and to evaluate their usefulness for the prediction of the initial response to sorafenib.
  
  
  METHODS
  Forty-eight patients with advanced HCC treated with sorafenib were evaluated by four-phase contrast-enhanced computed tomography. All target lesions were analyzed using the Response Evaluation Criteria in Solid Tumors (RECIST), the EASL criteria, and modified RECIST (mRECIST).
  
  
  RESULTS
  At the initial evaluation at 4-6 weeks, rates of objective response (OR) (including both complete and partial responses), stable disease (SD), and progressive disease (PD) were 2, 71, and 27 %, respectively, according to RECIST; 15, 56, and 29 %, respectively, according to the EASL criteria; and 15, 58, and 27 %, respectively, according to mRECIST. Patients who achieved an OR according to the EASL criteria also achieved an OR according to mRECIST. Patients who achieved an OR according to the EASL criteria or mRECIST had better predicted overall survival (OS) than did patients who achieved SD (p = 0.033 and 0.028, respectively). Patients with SD according to RECIST had different outcomes depending on the response according to enhancement criteria. Patients classified as responders (complete and partial) had better predicted OS than those classified as non-responders (those classified as SD and PD) (p = 0.048).
  
  
  CONCLUSIONS
  The enhancement criteria could be useful for prediction of the initial response to sorafenib in patients with HCC. Moreover, mRECIST appears to be simple and convenient.
authors.affiliation: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan. sadahisa@me.com.
authors.forename: Sadahisa
authors.initials: S
authors.lastname: Ogasawara
authors.affiliation: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Kanai
authors.affiliation: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Ooka
authors.affiliation: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
authors.forename: Tenyu
authors.initials: T
authors.lastname: Motoyama
authors.affiliation: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
authors.forename: Eiichiro
authors.initials: E
authors.lastname: Suzuki
authors.affiliation: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
authors.forename: Akinobu
authors.initials: A
authors.lastname: Tawada
authors.affiliation: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Chiba
authors.affiliation: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokosuka
keywords: Hepatocellular carcinoma; Initial response; RECIST; Sorafenib; The EASL criteria; mRECIST