title: Response to transarterial chemoembolization as a selection criterion for resection of hepatocellular carcinomas.
abstract: BACKGROUND
  Liver resection for intermediate (Barcelona Clinic Liver Cancer (BCLC) stage B) hepatocellular carcinoma (HCC) remains controversial. This study attempted to demonstrate the effectiveness of preresection transarterial chemoembolization (TACE) as a selection criterion for BCLC-B HCC.
  
  
  METHODS
  The study included patients with BCLC-B HCC who underwent liver resection after TACE. The tumour response to TACE was evaluated according to the modified Response Evaluation Criteria in Solid Tumours (mRECIST). Patients with a complete or partial response comprised the responder group, whereas those with stable or progressive disease were classified as non-responders.
  
  
  RESULTS
  A total of 242 patients were included. After between one and eight sessions of TACE, 141 patients were included in the responder group: 37 patients (15·3 per cent) who achieved a complete response and 104 who had a partial response. The cumulative 1-, 3- and 5-year overall survival rates were 97·2, 88·7 and 75·2 per cent respectively in the responder group, compared with 90·1, 67·3 and 53·5 per cent among 101 non-responders (P < 0·001). Tumour-free survival rates were also better among responders than non-responders (P < 0·001). In multivariable analysis, independent predictors of overall and tumour-free survival were response to TACE and microvascular invasion (all P < 0·001).
  
  
  CONCLUSIONS
  mRECIST may represent selection criterion for intermediate HCC for surgical treatment.
authors.affiliation: Thyroid and Parathyroid Surgery Centre, West China Hospital of Sichuan University, Chengdu, China.|Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China.|State Key Laboratory of Biotherapy/Collaborative Innovation Centre of Biotherapy, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: J Y
authors.initials: JY
authors.lastname: Lei
authors.affiliation: Department of Pathology, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: J J
authors.initials: JJ
authors.lastname: Zhong
authors.affiliation: Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: L N
authors.initials: LN
authors.lastname: Yan
authors.affiliation: Thyroid and Parathyroid Surgery Centre, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: J Q
authors.initials: JQ
authors.lastname: Zhu
authors.affiliation: Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: W T
authors.initials: WT
authors.lastname: Wang
authors.affiliation: Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zeng
authors.affiliation: Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: B
authors.initials: B
authors.lastname: Li
authors.affiliation: Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: T F
authors.initials: TF
authors.lastname: Wen
authors.affiliation: Transplantation Centre, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: J Y
authors.initials: JY
authors.lastname: Yang
mesh_terms: D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D002681:China / Q000453:epidemiology; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D009504:Neutrophils / Q000378:metabolism; D018579:Patient Selection; D012189:Retrospective Studies; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000903:Antibiotics, Antineoplastic; D000509:alpha-Fetoproteins; D004317:Doxorubicin