title: Predictors of treatment response following aspiration sclerotherapy of hepatic cysts: an international pooled analysis of individual patient data.
abstract: OBJECTIVE
  To identify predictive variables of treatment response following aspiration sclerotherapy of large symptomatic hepatic cysts.
  
  
  METHODS
  We collected individual patient data from two tertiary referral centres and included all patients treated with aspiration sclerotherapy of a large (>5 cm), symptomatic hepatic cyst. At six months, clinical response was defined as complete or incomplete. Secondary, suboptimal technical response was defined as lower quartile of cyst reduction. Predictive variables of clinical and technical response were analyzed by logistic regression analysis.
  
  
  RESULTS
  We included 86 patients (58 ± 10 years; female 90 %). Complete clinical response rate was 55 %. Median cyst diameter and volume reduction were 71 % (IQR 50-87 %) and 98 % (IRQ 88-100 %), respectively. Patients with complete clinical response had a significantly higher cyst reduction compared to incomplete responders (OR 1.02, 95 % CI 1.00-1.04). Aspiration of haemorrhagic cyst fluid (OR 4.39, 95 % CI 1.34-14.39) or a lower cyst reduction at one month (OR 1.06, 95 % CI 1.02-1.10) was associated with a suboptimal technical response at six months.
  
  
  CONCLUSIONS
  Complete clinical response is associated with effective cyst reduction. Aspiration of haemorrhagic cyst fluid or a restricted diameter reduction at one month predicts a suboptimal technical treatment response, however, these variables did not predict symptom disappearance.
  
  
  CONCLUSIONS
  • Aspiration sclerotherapy of hepatic cysts shows excellent clinical and technical efficacy. • Optimal clinical responders have a markedly higher cyst reduction. • Haemorrhagic aspirate and a strong fluid reaccumulation predict suboptimal cyst reduction.
authors.affiliation: Department of Gastroenterology and Hepatology, Radboud University Medical Center, P.O. Box 9101, code 455, 6500 HB, Nijmegen, The Netherlands.
authors.forename: Titus F M
authors.initials: TF
authors.lastname: Wijnands
authors.affiliation: Department of Radiology, Beaujon University Hospitals Paris Nord Val de Seine, Clichy, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Ronot
authors.affiliation: Department of Gastroenterology and Hepatology, Radboud University Medical Center, P.O. Box 9101, code 455, 6500 HB, Nijmegen, The Netherlands.
authors.forename: Tom J G
authors.initials: TJ
authors.lastname: Gevers
authors.affiliation: Department of Radiology, Beaujon University Hospitals Paris Nord Val de Seine, Clichy, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Benzimra
authors.affiliation: Department of Radiology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Leo J Schultze
authors.initials: LJ
authors.lastname: Kool
authors.affiliation: Department of Radiology, Beaujon University Hospitals Paris Nord Val de Seine, Clichy, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Vilgrain
authors.affiliation: Department of Gastroenterology and Hepatology, Radboud University Medical Center, P.O. Box 9101, code 455, 6500 HB, Nijmegen, The Netherlands. joostphdrenth@cs.com.
authors.forename: Joost P H
authors.initials: JP
authors.lastname: Drenth
mesh_terms: D000328:Adult; D000368:Aged; D003560:Cysts / Q000000981:diagnostic imaging / Q000628:therapy*; D004322:Drainage; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D015911:Sclerotherapy / Q000379:methods*; D013396:Suction; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D012597:Sclerosing Solutions; D000431:Ethanol
keywords: Drainage; Hepatic cyst; Interventional; Polycystic liver disease; Sclerotherapy