Radiographic response to locoregional therapy in hepatocellular carcinoma predicts patient survival times

Khairuddin Memon, Laura Kulik, Robert J. Lewandowski, Edward Wang, Ahsun Riaz, Robert K. Ryu, Kent T. Sato, Karen Marshall, Ramona Gupta, Paul Nikolaidis, Frank H. Miller, Vahid Yaghmai, Seanthan Senthilnathan, Talia Baker, Vanessa L. Gates, Michael Abecassis, Al B. Benson, Mary F. Mulcahy, Reed A. Omary, Riad Salem*

*Corresponding author for this work

Research output: Contribution to journalArticle

107 Citations (Scopus)

Abstract

Background & Aims: It is not clear whether survival times of patients with hepatocellular carcinoma (HCC) are associated with their response to therapy. We analyzed the association between tumor response and survival times of patients with HCC who were treated with locoregional therapies (LRTs) (chemoembolization and radioembolization). Methods: Patients received LRTs over a 9-year period (n = 463). Patients with metastases, portal venous thrombosis, or who had received transplants were excluded; 159 patients with ChildPugh B7 or lower were analyzed. Response (based on European Association for the Study of the Liver [EASL] and World Health Organization [WHO] criteria) was associated with survival times using the landmark, risk-of-death, and MantelByar methodologies. In a subanalysis, survival times of responders were compared with those of patients with stable disease and progressive disease. Results: Based on 6-month data, in landmark analysis, responders survived longer than nonresponders (based on EASL but not WHO criteria: P =.002 and.0694). The risk of death was also lower for responders (based on EASL but not WHO criteria: P =.0463 and.707). Landmark analysis of 12-month data showed that responders survived longer than nonresponders (P <.0001 and.004, based on EASL and WHO criteria, respectively). The risk of death was lower for responders (P =.0132 and.010, based on EASL and WHO criteria, respectively). By the MantelByar method, responders had longer survival than nonresponders, based on EASL criteria (P <.0001; P =.596 with WHO criteria). In the subanalysis, responders lived longer than patients with stable disease or progressive disease. Conclusions: Radiographic response to LRTs predicts survival time. EASL criteria for response more consistently predicted survival times than WHO criteria. The goal of LRT should be to achieve a radiologic response, rather than to stabilize disease.

Original languageEnglish (US)
JournalGastroenterology
Volume141
Issue number2
DOIs
StatePublished - Jan 1 2011

Fingerprint

Hepatocellular Carcinoma
Survival
Liver
Therapeutics
Venous Thrombosis
Neoplasm Metastasis
Transplants
Neoplasms

Keywords

  • Embolization
  • Liver Cancer
  • Radiology
  • Treatment

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

@article{bbdb9fda841a4a479b936dcf0beb6501,
title = "Radiographic response to locoregional therapy in hepatocellular carcinoma predicts patient survival times",
abstract = "Background & Aims: It is not clear whether survival times of patients with hepatocellular carcinoma (HCC) are associated with their response to therapy. We analyzed the association between tumor response and survival times of patients with HCC who were treated with locoregional therapies (LRTs) (chemoembolization and radioembolization). Methods: Patients received LRTs over a 9-year period (n = 463). Patients with metastases, portal venous thrombosis, or who had received transplants were excluded; 159 patients with ChildPugh B7 or lower were analyzed. Response (based on European Association for the Study of the Liver [EASL] and World Health Organization [WHO] criteria) was associated with survival times using the landmark, risk-of-death, and MantelByar methodologies. In a subanalysis, survival times of responders were compared with those of patients with stable disease and progressive disease. Results: Based on 6-month data, in landmark analysis, responders survived longer than nonresponders (based on EASL but not WHO criteria: P =.002 and.0694). The risk of death was also lower for responders (based on EASL but not WHO criteria: P =.0463 and.707). Landmark analysis of 12-month data showed that responders survived longer than nonresponders (P <.0001 and.004, based on EASL and WHO criteria, respectively). The risk of death was lower for responders (P =.0132 and.010, based on EASL and WHO criteria, respectively). By the MantelByar method, responders had longer survival than nonresponders, based on EASL criteria (P <.0001; P =.596 with WHO criteria). In the subanalysis, responders lived longer than patients with stable disease or progressive disease. Conclusions: Radiographic response to LRTs predicts survival time. EASL criteria for response more consistently predicted survival times than WHO criteria. The goal of LRT should be to achieve a radiologic response, rather than to stabilize disease.",
keywords = "Embolization, Liver Cancer, Radiology, Treatment",
author = "Khairuddin Memon and Laura Kulik and Lewandowski, {Robert J.} and Edward Wang and Ahsun Riaz and Ryu, {Robert K.} and Sato, {Kent T.} and Karen Marshall and Ramona Gupta and Paul Nikolaidis and Miller, {Frank H.} and Vahid Yaghmai and Seanthan Senthilnathan and Talia Baker and Gates, {Vanessa L.} and Michael Abecassis and Benson, {Al B.} and Mulcahy, {Mary F.} and Omary, {Reed A.} and Riad Salem",
year = "2011",
month = "1",
day = "1",
doi = "10.1053/j.gastro.2011.04.054",
language = "English (US)",
volume = "141",
journal = "Gastroenterology",
issn = "0016-5085",
publisher = "W.B. Saunders Ltd",
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}

Radiographic response to locoregional therapy in hepatocellular carcinoma predicts patient survival times. / Memon, Khairuddin; Kulik, Laura; Lewandowski, Robert J.; Wang, Edward; Riaz, Ahsun; Ryu, Robert K.; Sato, Kent T.; Marshall, Karen; Gupta, Ramona; Nikolaidis, Paul; Miller, Frank H.; Yaghmai, Vahid; Senthilnathan, Seanthan; Baker, Talia; Gates, Vanessa L.; Abecassis, Michael; Benson, Al B.; Mulcahy, Mary F.; Omary, Reed A.; Salem, Riad.

In: Gastroenterology, Vol. 141, No. 2, 01.01.2011.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Radiographic response to locoregional therapy in hepatocellular carcinoma predicts patient survival times

AU - Memon, Khairuddin

AU - Kulik, Laura

AU - Lewandowski, Robert J.

AU - Wang, Edward

AU - Riaz, Ahsun

AU - Ryu, Robert K.

AU - Sato, Kent T.

AU - Marshall, Karen

AU - Gupta, Ramona

AU - Nikolaidis, Paul

AU - Miller, Frank H.

AU - Yaghmai, Vahid

AU - Senthilnathan, Seanthan

AU - Baker, Talia

AU - Gates, Vanessa L.

AU - Abecassis, Michael

AU - Benson, Al B.

AU - Mulcahy, Mary F.

AU - Omary, Reed A.

AU - Salem, Riad

PY - 2011/1/1

Y1 - 2011/1/1

N2 - Background & Aims: It is not clear whether survival times of patients with hepatocellular carcinoma (HCC) are associated with their response to therapy. We analyzed the association between tumor response and survival times of patients with HCC who were treated with locoregional therapies (LRTs) (chemoembolization and radioembolization). Methods: Patients received LRTs over a 9-year period (n = 463). Patients with metastases, portal venous thrombosis, or who had received transplants were excluded; 159 patients with ChildPugh B7 or lower were analyzed. Response (based on European Association for the Study of the Liver [EASL] and World Health Organization [WHO] criteria) was associated with survival times using the landmark, risk-of-death, and MantelByar methodologies. In a subanalysis, survival times of responders were compared with those of patients with stable disease and progressive disease. Results: Based on 6-month data, in landmark analysis, responders survived longer than nonresponders (based on EASL but not WHO criteria: P =.002 and.0694). The risk of death was also lower for responders (based on EASL but not WHO criteria: P =.0463 and.707). Landmark analysis of 12-month data showed that responders survived longer than nonresponders (P <.0001 and.004, based on EASL and WHO criteria, respectively). The risk of death was lower for responders (P =.0132 and.010, based on EASL and WHO criteria, respectively). By the MantelByar method, responders had longer survival than nonresponders, based on EASL criteria (P <.0001; P =.596 with WHO criteria). In the subanalysis, responders lived longer than patients with stable disease or progressive disease. Conclusions: Radiographic response to LRTs predicts survival time. EASL criteria for response more consistently predicted survival times than WHO criteria. The goal of LRT should be to achieve a radiologic response, rather than to stabilize disease.

AB - Background & Aims: It is not clear whether survival times of patients with hepatocellular carcinoma (HCC) are associated with their response to therapy. We analyzed the association between tumor response and survival times of patients with HCC who were treated with locoregional therapies (LRTs) (chemoembolization and radioembolization). Methods: Patients received LRTs over a 9-year period (n = 463). Patients with metastases, portal venous thrombosis, or who had received transplants were excluded; 159 patients with ChildPugh B7 or lower were analyzed. Response (based on European Association for the Study of the Liver [EASL] and World Health Organization [WHO] criteria) was associated with survival times using the landmark, risk-of-death, and MantelByar methodologies. In a subanalysis, survival times of responders were compared with those of patients with stable disease and progressive disease. Results: Based on 6-month data, in landmark analysis, responders survived longer than nonresponders (based on EASL but not WHO criteria: P =.002 and.0694). The risk of death was also lower for responders (based on EASL but not WHO criteria: P =.0463 and.707). Landmark analysis of 12-month data showed that responders survived longer than nonresponders (P <.0001 and.004, based on EASL and WHO criteria, respectively). The risk of death was lower for responders (P =.0132 and.010, based on EASL and WHO criteria, respectively). By the MantelByar method, responders had longer survival than nonresponders, based on EASL criteria (P <.0001; P =.596 with WHO criteria). In the subanalysis, responders lived longer than patients with stable disease or progressive disease. Conclusions: Radiographic response to LRTs predicts survival time. EASL criteria for response more consistently predicted survival times than WHO criteria. The goal of LRT should be to achieve a radiologic response, rather than to stabilize disease.

KW - Embolization

KW - Liver Cancer

KW - Radiology

KW - Treatment

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U2 - 10.1053/j.gastro.2011.04.054

DO - 10.1053/j.gastro.2011.04.054

M3 - Article

C2 - 21664356

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JO - Gastroenterology

JF - Gastroenterology

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