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Does the Degree of Hepatocellular Carcinoma Tumor Necrosis following Transarterial Chemoembolization Impact Patient Survival?

Purpose. The association between transarterial chemoembolization- (TACE-) induced HCC tumor necrosis measured by the modified Response Evaluation Criteria In Solid Tumors (mRECIST) and patient survival is poorly defined. We hypothesize that survival will be superior in HCC patients with increased TA...

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Autores principales: Haywood, Nathan, Gennaro, Kyle, Obert, John, Sauer, Paul F., Redden, David T., Zarzour, Jessica, Smith, J. Kevin, Bolus, David, Saddekni, Souheil, Aal, Ahmed Kamel Abdel, Gray, Stephen, White, Jared, Eckhoff, Devin E., DuBay, Derek A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4754482/
https://www.ncbi.nlm.nih.gov/pubmed/26949394
http://dx.doi.org/10.1155/2016/4692139
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author Haywood, Nathan
Gennaro, Kyle
Obert, John
Sauer, Paul F.
Redden, David T.
Zarzour, Jessica
Smith, J. Kevin
Bolus, David
Saddekni, Souheil
Aal, Ahmed Kamel Abdel
Gray, Stephen
White, Jared
Eckhoff, Devin E.
DuBay, Derek A.
author_facet Haywood, Nathan
Gennaro, Kyle
Obert, John
Sauer, Paul F.
Redden, David T.
Zarzour, Jessica
Smith, J. Kevin
Bolus, David
Saddekni, Souheil
Aal, Ahmed Kamel Abdel
Gray, Stephen
White, Jared
Eckhoff, Devin E.
DuBay, Derek A.
author_sort Haywood, Nathan
collection PubMed
description Purpose. The association between transarterial chemoembolization- (TACE-) induced HCC tumor necrosis measured by the modified Response Evaluation Criteria In Solid Tumors (mRECIST) and patient survival is poorly defined. We hypothesize that survival will be superior in HCC patients with increased TACE-induced tumor necrosis. Materials and Methods. TACE interventions were retrospectively reviewed. Tumor response was quantified via dichotomized (responders and nonresponders) and the four defined mRECIST categories. Results. Median survival following TACE was significantly greater in responders compared to nonresponders (20.8 months versus 14.9 months, p = 0.011). Survival outcomes also significantly varied among the four mRECIST categories (p = 0.0003): complete, 21.4 months; partial, 20.8; stable, 16.8; and progressive, 7.73. Only progressive disease demonstrated significantly worse survival when compared to complete response. Multivariable analysis showed that progressive disease, increasing total tumor diameter, and non-Child-Pugh class A were independent predictors of post-TACE mortality. Conclusions. Both dichotomized (responders and nonresponders) and the four defined mRECIST responses to TACE in patients with HCC were predictive of survival. The main driver of the survival analysis was poor survival in the progressive disease group. Surprisingly, there was small nonsignificant survival benefit between complete, partial, and stable disease groups. These findings may inform HCC treatment decisions following first TACE.
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spelling pubmed-47544822016-03-06 Does the Degree of Hepatocellular Carcinoma Tumor Necrosis following Transarterial Chemoembolization Impact Patient Survival? Haywood, Nathan Gennaro, Kyle Obert, John Sauer, Paul F. Redden, David T. Zarzour, Jessica Smith, J. Kevin Bolus, David Saddekni, Souheil Aal, Ahmed Kamel Abdel Gray, Stephen White, Jared Eckhoff, Devin E. DuBay, Derek A. J Oncol Clinical Study Purpose. The association between transarterial chemoembolization- (TACE-) induced HCC tumor necrosis measured by the modified Response Evaluation Criteria In Solid Tumors (mRECIST) and patient survival is poorly defined. We hypothesize that survival will be superior in HCC patients with increased TACE-induced tumor necrosis. Materials and Methods. TACE interventions were retrospectively reviewed. Tumor response was quantified via dichotomized (responders and nonresponders) and the four defined mRECIST categories. Results. Median survival following TACE was significantly greater in responders compared to nonresponders (20.8 months versus 14.9 months, p = 0.011). Survival outcomes also significantly varied among the four mRECIST categories (p = 0.0003): complete, 21.4 months; partial, 20.8; stable, 16.8; and progressive, 7.73. Only progressive disease demonstrated significantly worse survival when compared to complete response. Multivariable analysis showed that progressive disease, increasing total tumor diameter, and non-Child-Pugh class A were independent predictors of post-TACE mortality. Conclusions. Both dichotomized (responders and nonresponders) and the four defined mRECIST responses to TACE in patients with HCC were predictive of survival. The main driver of the survival analysis was poor survival in the progressive disease group. Surprisingly, there was small nonsignificant survival benefit between complete, partial, and stable disease groups. These findings may inform HCC treatment decisions following first TACE. Hindawi Publishing Corporation 2016 2016-02-02 /pmc/articles/PMC4754482/ /pubmed/26949394 http://dx.doi.org/10.1155/2016/4692139 Text en Copyright © 2016 Nathan Haywood et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Haywood, Nathan
Gennaro, Kyle
Obert, John
Sauer, Paul F.
Redden, David T.
Zarzour, Jessica
Smith, J. Kevin
Bolus, David
Saddekni, Souheil
Aal, Ahmed Kamel Abdel
Gray, Stephen
White, Jared
Eckhoff, Devin E.
DuBay, Derek A.
Does the Degree of Hepatocellular Carcinoma Tumor Necrosis following Transarterial Chemoembolization Impact Patient Survival?
title Does the Degree of Hepatocellular Carcinoma Tumor Necrosis following Transarterial Chemoembolization Impact Patient Survival?
title_full Does the Degree of Hepatocellular Carcinoma Tumor Necrosis following Transarterial Chemoembolization Impact Patient Survival?
title_fullStr Does the Degree of Hepatocellular Carcinoma Tumor Necrosis following Transarterial Chemoembolization Impact Patient Survival?
title_full_unstemmed Does the Degree of Hepatocellular Carcinoma Tumor Necrosis following Transarterial Chemoembolization Impact Patient Survival?
title_short Does the Degree of Hepatocellular Carcinoma Tumor Necrosis following Transarterial Chemoembolization Impact Patient Survival?
title_sort does the degree of hepatocellular carcinoma tumor necrosis following transarterial chemoembolization impact patient survival?
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4754482/
https://www.ncbi.nlm.nih.gov/pubmed/26949394
http://dx.doi.org/10.1155/2016/4692139
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