Complete response at first chemoembolization is still the most robust predictor for favorable outcome in hepatocellular carcinoma

Beom Kyung Kim, Seungup Kim, Kyung Ah Kim, Yong Eun Chung, Myeong Jin Kim, Mi Suk Park, Junyong Park, doyoung kim, SangHoon Ahn, ManDeuk Kim, Sung Il Park, Jong Yoon Won, Do Yun Lee, KwangHyub Han

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Backgrounds & Aims The aim of this study is to evaluate the prognostic significances of not only the initial and the best response during repeated transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC), but if eligible, also the time point of achieving treatment responses. Methods Three hundred and fourteen treatment-naïve patients with well-preserved liver function undergoing TACE were recruited. Treatment responses were assessed using modified Response Evaluation Criteria in Solid Tumors. Overall survival (OS) was analyzed using Kaplan-Meier methods, and Cox regression analysis was performed for multivariate analysis. Results After adjusting other variables, objective response (complete response [CR] and partial response [PR]) as the initial response (adjusted hazard ratio [HR] 0.410) and the best response (adjusted HR 0.335) had independent prognostic significances for OS, respectively (both p <0.001). Objective responders as the initial response had the longest OS, followed by patients who subsequently achieved objective response after at least two sessions and those who did not achieve objective response during treatment course eventually (52.6, 27.0, and 10.8 months, respectively; log-rank test, p <0.001). Likewise, patients with CR as the initial response had the longest OS, followed by those who subsequently achieved CR after at least two sessions and those who achieved PR as the best response (70.2, 40.6, and 23.0 months, respectively; log-rank test, p <0.001). Large (>5 cm) and multiple (â>4) tumors were independently associated with failure to achieve CR after the initial TACE (both p <0.05). Conclusion Both the initial and the best response predicts OS effectively. However, achievement of treatment response at an early time point is still the most robust predictor for favorable outcomes.

Original languageEnglish
Article number5525
Pages (from-to)1304-1310
Number of pages7
JournalJournal of Hepatology
Volume62
Issue number6
DOIs
Publication statusPublished - 2015 Jun 1

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Hepatocellular Carcinoma
Survival
Therapeutics
Multivariate Analysis
Regression Analysis
Liver
Neoplasms

All Science Journal Classification (ASJC) codes

  • Hepatology

Cite this

Kim, Beom Kyung ; Kim, Seungup ; Kim, Kyung Ah ; Chung, Yong Eun ; Kim, Myeong Jin ; Park, Mi Suk ; Park, Junyong ; kim, doyoung ; Ahn, SangHoon ; Kim, ManDeuk ; Park, Sung Il ; Won, Jong Yoon ; Lee, Do Yun ; Han, KwangHyub. / Complete response at first chemoembolization is still the most robust predictor for favorable outcome in hepatocellular carcinoma. In: Journal of Hepatology. 2015 ; Vol. 62, No. 6. pp. 1304-1310.
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abstract = "Backgrounds & Aims The aim of this study is to evaluate the prognostic significances of not only the initial and the best response during repeated transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC), but if eligible, also the time point of achieving treatment responses. Methods Three hundred and fourteen treatment-na{\"i}ve patients with well-preserved liver function undergoing TACE were recruited. Treatment responses were assessed using modified Response Evaluation Criteria in Solid Tumors. Overall survival (OS) was analyzed using Kaplan-Meier methods, and Cox regression analysis was performed for multivariate analysis. Results After adjusting other variables, objective response (complete response [CR] and partial response [PR]) as the initial response (adjusted hazard ratio [HR] 0.410) and the best response (adjusted HR 0.335) had independent prognostic significances for OS, respectively (both p <0.001). Objective responders as the initial response had the longest OS, followed by patients who subsequently achieved objective response after at least two sessions and those who did not achieve objective response during treatment course eventually (52.6, 27.0, and 10.8 months, respectively; log-rank test, p <0.001). Likewise, patients with CR as the initial response had the longest OS, followed by those who subsequently achieved CR after at least two sessions and those who achieved PR as the best response (70.2, 40.6, and 23.0 months, respectively; log-rank test, p <0.001). Large (>5 cm) and multiple ({\^a}>4) tumors were independently associated with failure to achieve CR after the initial TACE (both p <0.05). Conclusion Both the initial and the best response predicts OS effectively. However, achievement of treatment response at an early time point is still the most robust predictor for favorable outcomes.",
author = "Kim, {Beom Kyung} and Seungup Kim and Kim, {Kyung Ah} and Chung, {Yong Eun} and Kim, {Myeong Jin} and Park, {Mi Suk} and Junyong Park and doyoung kim and SangHoon Ahn and ManDeuk Kim and Park, {Sung Il} and Won, {Jong Yoon} and Lee, {Do Yun} and KwangHyub Han",
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Complete response at first chemoembolization is still the most robust predictor for favorable outcome in hepatocellular carcinoma. / Kim, Beom Kyung; Kim, Seungup; Kim, Kyung Ah; Chung, Yong Eun; Kim, Myeong Jin; Park, Mi Suk; Park, Junyong; kim, doyoung; Ahn, SangHoon; Kim, ManDeuk; Park, Sung Il; Won, Jong Yoon; Lee, Do Yun; Han, KwangHyub.

In: Journal of Hepatology, Vol. 62, No. 6, 5525, 01.06.2015, p. 1304-1310.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Complete response at first chemoembolization is still the most robust predictor for favorable outcome in hepatocellular carcinoma

AU - Kim, Beom Kyung

AU - Kim, Seungup

AU - Kim, Kyung Ah

AU - Chung, Yong Eun

AU - Kim, Myeong Jin

AU - Park, Mi Suk

AU - Park, Junyong

AU - kim, doyoung

AU - Ahn, SangHoon

AU - Kim, ManDeuk

AU - Park, Sung Il

AU - Won, Jong Yoon

AU - Lee, Do Yun

AU - Han, KwangHyub

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Backgrounds & Aims The aim of this study is to evaluate the prognostic significances of not only the initial and the best response during repeated transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC), but if eligible, also the time point of achieving treatment responses. Methods Three hundred and fourteen treatment-naïve patients with well-preserved liver function undergoing TACE were recruited. Treatment responses were assessed using modified Response Evaluation Criteria in Solid Tumors. Overall survival (OS) was analyzed using Kaplan-Meier methods, and Cox regression analysis was performed for multivariate analysis. Results After adjusting other variables, objective response (complete response [CR] and partial response [PR]) as the initial response (adjusted hazard ratio [HR] 0.410) and the best response (adjusted HR 0.335) had independent prognostic significances for OS, respectively (both p <0.001). Objective responders as the initial response had the longest OS, followed by patients who subsequently achieved objective response after at least two sessions and those who did not achieve objective response during treatment course eventually (52.6, 27.0, and 10.8 months, respectively; log-rank test, p <0.001). Likewise, patients with CR as the initial response had the longest OS, followed by those who subsequently achieved CR after at least two sessions and those who achieved PR as the best response (70.2, 40.6, and 23.0 months, respectively; log-rank test, p <0.001). Large (>5 cm) and multiple (â>4) tumors were independently associated with failure to achieve CR after the initial TACE (both p <0.05). Conclusion Both the initial and the best response predicts OS effectively. However, achievement of treatment response at an early time point is still the most robust predictor for favorable outcomes.

AB - Backgrounds & Aims The aim of this study is to evaluate the prognostic significances of not only the initial and the best response during repeated transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC), but if eligible, also the time point of achieving treatment responses. Methods Three hundred and fourteen treatment-naïve patients with well-preserved liver function undergoing TACE were recruited. Treatment responses were assessed using modified Response Evaluation Criteria in Solid Tumors. Overall survival (OS) was analyzed using Kaplan-Meier methods, and Cox regression analysis was performed for multivariate analysis. Results After adjusting other variables, objective response (complete response [CR] and partial response [PR]) as the initial response (adjusted hazard ratio [HR] 0.410) and the best response (adjusted HR 0.335) had independent prognostic significances for OS, respectively (both p <0.001). Objective responders as the initial response had the longest OS, followed by patients who subsequently achieved objective response after at least two sessions and those who did not achieve objective response during treatment course eventually (52.6, 27.0, and 10.8 months, respectively; log-rank test, p <0.001). Likewise, patients with CR as the initial response had the longest OS, followed by those who subsequently achieved CR after at least two sessions and those who achieved PR as the best response (70.2, 40.6, and 23.0 months, respectively; log-rank test, p <0.001). Large (>5 cm) and multiple (â>4) tumors were independently associated with failure to achieve CR after the initial TACE (both p <0.05). Conclusion Both the initial and the best response predicts OS effectively. However, achievement of treatment response at an early time point is still the most robust predictor for favorable outcomes.

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