Renal cell carcinoma metastatic to the liver: Early response assessment after intraarterial therapy using 3D quantitative tumor enhancement analysis

Florian Nima Fleckenstein, Rüdiger Egbert Schernthaner, Rafael Duran, Jae Ho Sohn, Sonia Sahu, Karen Marshall, Ming De Lin, Bernhard Gebauer, Julius Chapiro, Riad Salem, Jean François Geschwind*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


PURPOSE: Liver metastases from renal cell carcinoma (RCC) are not uncommon in the course of disease. However, data about tumor response to intraarterial therapy (IAT) are scarce. This study assessed whether changes of enhancing tumor volume using quantitative European Association for the Study of the Liver (qEASL) on magnetic resonance imaging (MRI) and computed tomography (CT) can evaluate tumor response and predict overall survival (OS) early after therapy. METHODS AND MATERIALS: Fourteen patients with liver metastatic RCC treated with IAT (transarterial chemoembolization: n= 9 and yttrium-90: n= 5) were retrospectively included. All patients underwent contrastenhanced imaging (MRI: n= 10 and CT: n= 4) 3 to 4 weeks pre-and posttreatment. Response to treatment was evaluated on the arterial phase using Response EvaluationCriteria in Solid Tumors (RECIST),World HealthOrganization, modified RECIST, EASL, tumor volume, and qEASL. Paired t test was used to comparemeasurements pre-and post-IAT. Patients were stratified into responders (≥65%decrease in qEASL) and nonresponders (b65% decrease in qEASL). OS was evaluated using Kaplan-Meier curves with log-rank test and the Cox proportional hazard model. RESULTS: Mean qEASL (cm3) decreased from 93.5 to 67.2 cm3 (P=.004) and mean qEASL (%) from 63.1% to 35.6% (P=.001). No significant changes were observed using other response criteria. qEASL was the only significant predictor of OS when used to stratify patients into responders and nonresponders with median OS of 31.9 versus 11.1 months (hazard ratio [HR], 0.43; 95% confidence interval [CI], 0.19-0.97; P=.042) for qEASL (cm3) and 29.9 versus 10.2 months (HR, 0.09; 95% CI, 0.01-0.74; P=.025) for qEASL (%). CONCLUSION: Three-dimensional (3D) quantitative tumor analysis is a reliable predictor ofOSwhen assessing treatment response after IAT in patients withRCCmetastatic to the liver. qEASL outperforms conventional non-3D methods and can be used as a surrogate marker for OS early after therapy.

Original languageEnglish (US)
Pages (from-to)377-383
Number of pages7
JournalTranslational Oncology
Issue number5
StatePublished - Oct 2016

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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