title: CT imaging findings in patients with advanced hepatocellular carcinoma treated with sorafenib: Alternative response criteria (Choi, European Association for the Study of the Liver, and modified Response Evaluation Criteria in Solid Tumor (mRECIST)) versus RECIST 1.1.
abstract: OBJECTIVE
  The first aim was to compare Response Evaluation Criteria in Solid Tumor (RECIST) 1.1, modified Response Evaluation Criteria in Solid Tumor (mRECIST), Choi and European Association for the Study of the Liver (EASL) evaluations to assess the response to sorafenib for hepatocellular carcinoma (HCC). The second aim was to describe the evolution of HCC and to identify whether some imaging features are predictive of the absence of response.
  
  
  METHODS
  This retrospective study included 60 patients with advanced HCC treated with sorafenib. Patients must have undergone a scan prior to treatment to identify the number of lesions, size, enhancement and endoportal invasions, and repeat scans thereafter. Computed tomography (CT) scans were analyzed using RECIST 1.1, mRECIST, Choi and EASL criteria. Overall survival was analyzed.
  
  
  RESULTS
  The median overall survival was 10.5 months. On the first CT reevaluation, the sorafenib response rates were 20%, 5%, 7% and 3% according to Choi, EASL, mRECIST and RECIST 1.1. The responders based on Choi exhibited significantly better overall survival compared with non-responders (20.4 months; hazard ratio (HR) 0.042, 95% confidence interval (CI): 0.186-0.94, p=0.035). A modification of imaging findings was observed in 48.3% of patients, and necrosis was present in 44.1% of patients.
  
  
  CONCLUSIONS
  This study found a significant difference between Choi versus RECIST 1.1, mRECIST and EASL when evaluating the response to sorafenib in HCC patients.
authors.affiliation: CHU Nancy, Department of Radiology, Brabois Adults Hospital, Nancy F-54000, France. Electronic address: melanie.girard@hotmail.fr.
authors.forename: M
authors.initials: M
authors.lastname: Gavanier
authors.affiliation: CHU Nancy, Department of Abdominal Surgery, Nancy F-54000, France; Universite de Lorraine, Faculte de Medecine, Nancy F-54000, France.
authors.forename: A
authors.initials: A
authors.lastname: Ayav
authors.affiliation: CHU Nancy, Department of Radiology, Brabois Adults Hospital, Nancy F-54000, France; Universite de Lorraine, Faculte de Medecine, Nancy F-54000, France.
authors.forename: C
authors.initials: C
authors.lastname: Sellal
authors.affiliation: CHU Nancy, Department of Radiology, Brabois Adults Hospital, Nancy F-54000, France; Universite de Lorraine, Faculte de Medecine, Nancy F-54000, France.
authors.forename: X
authors.initials: X
authors.lastname: Orry
authors.affiliation: CHU Nancy, Department of Radiology, Brabois Adults Hospital, Nancy F-54000, France; Universite de Lorraine, Faculte de Medecine, Nancy F-54000, France; INSERM, U947, IADI, Nancy F-54000, France.
authors.forename: M
authors.initials: M
authors.lastname: Claudon
authors.affiliation: Universite de Lorraine, Faculte de Medecine, Nancy F-54000, France; CHU Nancy, Department of Hepato Gastro Enterology, Nancy F-54000, France.
authors.forename: J P
authors.initials: JP
authors.lastname: Bronowicki
authors.affiliation: CHU Nancy, Department of Radiology, Brabois Adults Hospital, Nancy F-54000, France; Universite de Lorraine, Faculte de Medecine, Nancy F-54000, France; INSERM, U947, IADI, Nancy F-54000, France.
authors.forename: V
authors.initials: V
authors.lastname: Laurent
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use*; D016016:Proportional Hazards Models; D066066:Response Evaluation Criteria in Solid Tumors; D012189:Retrospective Studies; D000077157:Sorafenib; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib
keywords: Anti-angiogenic therapy; Choi; Hepatocellular carcinoma; RECIST 1.1; Tumoral response assessment; mRECIST