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RESEARCH PRODUCT
Prognostic Relevance of Objective Response According to EASL Criteria and mRECIST Criteria in Hepatocellular Carcinoma Patients Treated with Loco-Regional Therapies: A Literature-Based Meta-Analysis.
Marianna SillettaGennaro DanieleChiara SpotoGiuseppe BronteMassimo Di MaioMaria Carmela PiccirilloTonini GiuseppeAntonio RussoEliana MaciVincenzi BrunoFrancesca ComitoLoretta D'onofrioFrancesco PerroneSantini Danielesubject
OncologyGenetics and Molecular Biology (all)medicine.medical_specialtyCarcinoma HepatocellularPrognosiConcordancePopulationMEDLINElcsh:MedicineCarcinoma Hepatocellular; Humans; Liver Neoplasms; Prognosis; Survival Analysis; Treatment Outcome; Biochemistry Genetics and Molecular Biology (all); Agricultural and Biological Sciences (all)Cochrane LibraryBiochemistryInternal medicinemedicineHumanseducationlcsh:ScienceSurvival analysiseducation.field_of_studyMultidisciplinaryBiochemistry Genetics and Molecular Biology (all)Carcinoma Hepatocellular; Humans; Liver Neoplasms; Prognosis; Survival Analysis; Treatment Outcome; Agricultural and Biological Sciences (all); Biochemistry Genetics and Molecular Biology (all); Medicine (all)business.industryMedicine (all)CarcinomaLiver Neoplasmslcsh:RHepatocellularPrognosisSurvival AnalysisConfidence intervalSurgeryTreatment OutcomeAgricultural and Biological Sciences (all)Response Evaluation Criteria in Solid TumorsLiver NeoplasmMeta-analysislcsh:QSurvival AnalysibusinessHumanResearch Articledescription
Background The European Association for the Study of the Liver (EASL) criteria and the modified Response Evaluation Criteria in Solid Tumors (mRECIST) are currently adopted to evaluate radiological response in patients affected by HCC and treated with loco-regional procedures. Several studies explored the validity of these measurements in predicting survival but definitive data are still lacking. Aim To conduct a systematic review of studies exploring mRECIST and EASL criteria usefulness in predictive radiological response in HCC undergoing loco-regional therapies and their validity in predicting survival. Methods A comprehensive search of the literature was performed in electronic databases EMBASE, MEDLINE, COCHRANE LIBRARY, ASCO conferences and EASL conferences up to June 10, 2014. Our overall search strategy included terms for HCC, mRECIST, and EASL. Loco-regional procedures included transarterial embolization (TAE), transarterial chemoembolization (TACE) and cryoablation. Inter-method agreement between EASL and mRECIST was assessed using the k coefficient. For each criteria, overall survival was described in responders vs. non-responders patients, considering all target lesions response. Results Among 18 initially found publications, 7 reports including 1357 patients were considered eligible. All studies were published as full-text articles. Proportion of responders according to mRECIST and EASL criteria was 62.4% and 61.3%, respectively. In the pooled population, 1286 agreements were observed between the two methods (kappa statistics 0.928, 95% confidence interval 0.912–0.944). HR for overall survival (responders versus non responders) according to mRECIST and EASL was 0.39 (95% confidence interval 0.26–0.61, p<0.0001) and 0.38 (95% confidence interval 0.24–0.61, p<0.0001), respectively. Conclusion In this literature-based meta-analysis, mRECIST and EASL criteria showed very good concordance in HCC patients undergoing loco-regional treatments. Objective response according to both criteria confirms a strong prognostic value in terms of overall survival. This prognostic value appears to be very similar between the two criteria.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2015-01-01 | PLoS ONE |