Cargando…

Renal Cell Carcinoma Metastatic to the Liver: Early Response Assessment after Intraarterial Therapy Using 3D Quantitative Tumor Enhancement Analysis

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 th...

Descripción completa

Detalles Bibliográficos
Autores principales: Fleckenstein, Florian Nima, Schernthaner, Rüdiger Egbert, Duran, Rafael, Sohn, Jae Ho, Sahu, Sonia, Marshall, Karen, Lin, MingDe, Gebauer, Bernhard, Chapiro, Julius, Salem, Riad, Geschwind, Jean-François
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Neoplasia Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5021812/
https://www.ncbi.nlm.nih.gov/pubmed/27641641
http://dx.doi.org/10.1016/j.tranon.2016.07.005
_version_ 1782453397773877248
author Fleckenstein, Florian Nima
Schernthaner, Rüdiger Egbert
Duran, Rafael
Sohn, Jae Ho
Sahu, Sonia
Marshall, Karen
Lin, MingDe
Gebauer, Bernhard
Chapiro, Julius
Salem, Riad
Geschwind, Jean-François
author_facet Fleckenstein, Florian Nima
Schernthaner, Rüdiger Egbert
Duran, Rafael
Sohn, Jae Ho
Sahu, Sonia
Marshall, Karen
Lin, MingDe
Gebauer, Bernhard
Chapiro, Julius
Salem, Riad
Geschwind, Jean-François
author_sort Fleckenstein, Florian Nima
collection PubMed
description 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 contrast-enhanced 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 Evaluation Criteria in Solid Tumors (RECIST), World Health Organization, modified RECIST, EASL, tumor volume, and qEASL. Paired t test was used to compare measurements pre- and post-IAT. Patients were stratified into responders (≥65% decrease in qEASL) and nonresponders (<65% decrease in qEASL). OS was evaluated using Kaplan-Meier curves with log-rank test and the Cox proportional hazard model. RESULTS: Mean qEASL (cm(3)) decreased from 93.5 to 67.2 cm(3) (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 (cm(3)) 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 of OS when assessing treatment response after IAT in patients with RCC metastatic to the liver. qEASL outperforms conventional non-3D methods and can be used as a surrogate marker for OS early after therapy.
format Online
Article
Text
id pubmed-5021812
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Neoplasia Press
record_format MEDLINE/PubMed
spelling pubmed-50218122016-09-22 Renal Cell Carcinoma Metastatic to the Liver: Early Response Assessment after Intraarterial Therapy Using 3D Quantitative Tumor Enhancement Analysis Fleckenstein, Florian Nima Schernthaner, Rüdiger Egbert Duran, Rafael Sohn, Jae Ho Sahu, Sonia Marshall, Karen Lin, MingDe Gebauer, Bernhard Chapiro, Julius Salem, Riad Geschwind, Jean-François Transl Oncol Original article 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 contrast-enhanced 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 Evaluation Criteria in Solid Tumors (RECIST), World Health Organization, modified RECIST, EASL, tumor volume, and qEASL. Paired t test was used to compare measurements pre- and post-IAT. Patients were stratified into responders (≥65% decrease in qEASL) and nonresponders (<65% decrease in qEASL). OS was evaluated using Kaplan-Meier curves with log-rank test and the Cox proportional hazard model. RESULTS: Mean qEASL (cm(3)) decreased from 93.5 to 67.2 cm(3) (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 (cm(3)) 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 of OS when assessing treatment response after IAT in patients with RCC metastatic to the liver. qEASL outperforms conventional non-3D methods and can be used as a surrogate marker for OS early after therapy. Neoplasia Press 2016-09-12 /pmc/articles/PMC5021812/ /pubmed/27641641 http://dx.doi.org/10.1016/j.tranon.2016.07.005 Text en © 2016 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original article
Fleckenstein, Florian Nima
Schernthaner, Rüdiger Egbert
Duran, Rafael
Sohn, Jae Ho
Sahu, Sonia
Marshall, Karen
Lin, MingDe
Gebauer, Bernhard
Chapiro, Julius
Salem, Riad
Geschwind, Jean-François
Renal Cell Carcinoma Metastatic to the Liver: Early Response Assessment after Intraarterial Therapy Using 3D Quantitative Tumor Enhancement Analysis
title Renal Cell Carcinoma Metastatic to the Liver: Early Response Assessment after Intraarterial Therapy Using 3D Quantitative Tumor Enhancement Analysis
title_full Renal Cell Carcinoma Metastatic to the Liver: Early Response Assessment after Intraarterial Therapy Using 3D Quantitative Tumor Enhancement Analysis
title_fullStr Renal Cell Carcinoma Metastatic to the Liver: Early Response Assessment after Intraarterial Therapy Using 3D Quantitative Tumor Enhancement Analysis
title_full_unstemmed Renal Cell Carcinoma Metastatic to the Liver: Early Response Assessment after Intraarterial Therapy Using 3D Quantitative Tumor Enhancement Analysis
title_short Renal Cell Carcinoma Metastatic to the Liver: Early Response Assessment after Intraarterial Therapy Using 3D Quantitative Tumor Enhancement Analysis
title_sort renal cell carcinoma metastatic to the liver: early response assessment after intraarterial therapy using 3d quantitative tumor enhancement analysis
topic Original article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5021812/
https://www.ncbi.nlm.nih.gov/pubmed/27641641
http://dx.doi.org/10.1016/j.tranon.2016.07.005
work_keys_str_mv AT fleckensteinfloriannima renalcellcarcinomametastatictotheliverearlyresponseassessmentafterintraarterialtherapyusing3dquantitativetumorenhancementanalysis
AT schernthanerrudigeregbert renalcellcarcinomametastatictotheliverearlyresponseassessmentafterintraarterialtherapyusing3dquantitativetumorenhancementanalysis
AT duranrafael renalcellcarcinomametastatictotheliverearlyresponseassessmentafterintraarterialtherapyusing3dquantitativetumorenhancementanalysis
AT sohnjaeho renalcellcarcinomametastatictotheliverearlyresponseassessmentafterintraarterialtherapyusing3dquantitativetumorenhancementanalysis
AT sahusonia renalcellcarcinomametastatictotheliverearlyresponseassessmentafterintraarterialtherapyusing3dquantitativetumorenhancementanalysis
AT marshallkaren renalcellcarcinomametastatictotheliverearlyresponseassessmentafterintraarterialtherapyusing3dquantitativetumorenhancementanalysis
AT linmingde renalcellcarcinomametastatictotheliverearlyresponseassessmentafterintraarterialtherapyusing3dquantitativetumorenhancementanalysis
AT gebauerbernhard renalcellcarcinomametastatictotheliverearlyresponseassessmentafterintraarterialtherapyusing3dquantitativetumorenhancementanalysis
AT chapirojulius renalcellcarcinomametastatictotheliverearlyresponseassessmentafterintraarterialtherapyusing3dquantitativetumorenhancementanalysis
AT salemriad renalcellcarcinomametastatictotheliverearlyresponseassessmentafterintraarterialtherapyusing3dquantitativetumorenhancementanalysis
AT geschwindjeanfrancois renalcellcarcinomametastatictotheliverearlyresponseassessmentafterintraarterialtherapyusing3dquantitativetumorenhancementanalysis