The Modified Response Evaluation Criteria in Solid Tumors (RECIST) Yield a More Accurate Prognoses Than the RECIST 1.1 in Hepatocellular Carcinoma Treated with Transarterial Radioembolization

• Published in: Gut and liver Vol. 14; no. 6; pp. 765 - 774
• Main Authors: Lee, Jae Seung, Choi, Hong Jun, Kim, Beom Kyung, Park, Jun Yong, Kim, Do Young, Ahn, Sang Hoon, Han, Kwang-Hyub, Baek, Song-Ee, Chung, Yong Eun, Park, Mi-Suk, Kim, Myeong-Jin, Rhee, Hyungjin, Kim, Seung Up
• Format: Journal Article
• Language: English
• Published: Korea (South) Editorial Office of Gut and Liver 01.11.2020; Gastroenterology Council for Gut and Liver; 거트앤리버 소화기연관학회협의회
• Subjects: carcinoma; embolization; hepatocellular; Original; radiotherapy; response evaluation criteria in solid tumors; therapeutics; treatment outcome; 내과학; Carcinoma, hepatocellular; Treatment outcome; Response Evaluation Criteria in Solid Tumors; Radiotherapy; Embolization, therapeutics
• ISSN: 1976-2283; 2005-1212; 2005-1212
• DOI: 10.5009/gnl19197

The Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and modified RECIST (mRECIST) criteria have been used to assess treatment responses for hepatocellular carcinoma (HCC) patients. We investigated which criteria provides better survival predictions in HCC patients treated with transarterial radioembolization (TARE). In total, 102 patients with unresectable intrahepatic HCC, who were treated with TARE between 2012 and 2017, were reviewed retrospectively. The treatment response after TARE was evaluated at 1, 3, and 6 months by the mRECIST and RECIST 1.1. Responders were defined as patients with complete or partial responses by each criterion. The median age of 83 men and 19 women was 64.3 years. The median alpha-fetoprotein and des-gamma-carboxy prothrombin levels were 37.1 ng/mL and 1,780.0 mAU/mL, respectively. The median maximal tumor size was 8.3 cm, and multiple tumors were observed in 36 patients (35.3%). During the follow-up period (median, 20.7 months), 21 patients (20.6%) died, with a mean survival time of 55.5 months. The cumulative survival rate was 96.1% at 6 months and 89.3% at 12 months. Responders, defined by the mRECIST at 1, 3, and 6 months after TARE, showed better survival outcomes than nonresponders (hazard ratio [HR]=5.736, p=0.008 at 1 month; HR=3.145, p=0.022 at 3 months, and HR=2.887, p=0.061 at 6 months). The survival rates of responders and nonresponders defined by the RECIST 1.1 were similar (all p>0.05). Response evaluations that use the mRECIST provide more accurate prognoses than those that use the RECIST 1.1 in HCC patients treated with TARE.