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首页> 外文期刊>Hepatology: Official Journal of the American Association for the Study of Liver Diseases >Radioembolization for hepatocellular carcinoma: Statistical confirmation of improved survival in responders by landmark analyses
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Radioembolization for hepatocellular carcinoma: Statistical confirmation of improved survival in responders by landmark analyses

机译：肝细胞癌放射性栓塞：地标分析提高响应者提高存活的统计证实

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摘要

Does imaging response predict survival in hepatocellular carcinoma (HCC)? We studied the ability of posttherapeutic imaging response to predict overall survival. Over 14 years, 948 patients with HCC were treated with radioembolization. Patients with baseline metastases, vascular invasion, multifocal disease, Child‐Pugh??B7, and transplanted/resected were excluded. This created our homogeneous study cohort of 134 patients with Child‐Pugh?≤?B7 and solitary HCC. Response (using European Association for Study of the Liver [EASL] and Response Evaluation Criteria in Solid Tumors 1.1 [RECIST 1.1] criteria) was associated with survival using Landmark and risk‐of‐death methodologies after reviewing 960 scans. In a subanalysis, survival times of responders were compared to those of patients with stable disease (SD) and progressive disease (PD). Uni/multivariate survival analyses were performed at each Landmark. At the 3‐month Landmark, responders survived longer than nonresponders by EASL (hazard ratio [HR], 0.46; confidence interval [CI], 0.26‐0.82; P ?=?0.002) but not RECIST 1.1 criteria (HR, 0.70; CI, 0.37‐1.32; P ?=?0.32). At the 6‐month Landmark, responders survived longer than nonresponders by EASL (HR, 0.32; CI, 0.15‐0.77; P ??0.001) and RECIST 1.1 criteria (HR, 0.50; CI, 0.29‐0.87; P ?=?0.021). At the 12‐month Landmark, responders survived longer than nonresponders by EASL (HR, 0.34; CI, 0.15‐0.77; P?? 0.001) and RECIST 1.1 criteria (HR, 0.52; CI 0.27‐0.98; P ?=?0.049). At 6 months, risk of death was lower for responders by EASL ( P?? 0.001) and RECIST 1.1 ( P ?=?0.0445). In subanalyses, responders lived longer than patients with SD or PD. EASL response was a significant predictor of survival at 3‐, 6‐, and 12‐month Landmarks on uni/multivariate analyses. Conclusion : Response to radioembolization in patients with solitary HCC can prognosticate improved survival. EASL necrosis criteria outperformed RECIST 1.1 size criteria in predicting survival. The therapeutic objective of radioembolization should be radiologic response and not solely to prevent progression. (H epatology 2018;67:873–883)
机译：成像反应是否预测肝细胞癌（HCC）的存活？我们研究了术后术后成像对预测整体存活的能力。 14多年来，948例HCC患者被释放栓塞治疗。患者基线转移，血管侵袭，多焦疾病，儿童Pugh？＆？B7，并被移植/切除被排除在外。这创造了我们的均匀学习队列的134名儿童-PUGH患者？≤？B7和孤零零的HCC。响应（利用欧洲研究肝脏肝脏研究和实体肿瘤的响应评估标准1.1 [再循环1.1]标准）与在审查960扫描后使用地标和死亡风险方法的存活与存活相关。在一个细分分析中，将响应者的存活时间与稳定疾病（SD）和渐进性疾病（PD）的患者进行比较。在每个地标下进行UNI /多变量存活分析。在3个月的地标，响应者通过EASL（危险比[HR]，0.46;置信区间[CI]，0.26-0.82; P？0.002）而不是重新入住1.1标准（HR，0.70; ci ，0.37-1.32; p？= 0.32）。在6个月的地标，响应者通过EASL（HR，0.32; CI，0.15-0.77;p≤1.1.001）和重新入住1.1标准（HR，0.50; CI，0.29-0.87; P？= ？0.021）。在12个月的地标，响应者通过EASL（HR，0.34; CI，0.15-0.77;p≤1.1标准（HR，0.52; CI 0.27-0.98; P？=？ 0.049）。在6个月时，EASL（p？<0.001）和再循环率为1.1（p？= 0.0445）的响应者死亡风险降低。在SubanAlyses中，响应者比SD或PD的患者更长。 EASL响应是在UNI / Multivariate分析的3个，6岁和12个月的地标中存在的重要预测因素。结论：孤立性HCC患者的响应响应患者可以预后改善的存活。 EASL坏死标准优于预测生存率的111尺寸标准。放射性栓塞的治疗目标应该是放射学反应，不仅仅是防止进展。 （2018年，2018; 67：873-883）

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  • 作者

    Riaz Ahsun; Gabr Ahmed; Abouchaleh Nadine; Ali Rehan; Al Asadi Ali; Mora Ronald; Kulik Laura; Desai Kush; Thornburg Bartley; Mouli Samdeep; Hickey Ryan; Miller Frank H.; Yaghmai Vahid; Ganger Daniel; Lewandowski Robert J.; Salem Riad;

  • 作者单位

    Department of RadiologySection of Interventional Radiology Northwestern Memorial Hospital Robert;

    Department of RadiologySection of Interventional Radiology Northwestern Memorial Hospital Robert;

    Department of RadiologySection of Interventional Radiology Northwestern Memorial Hospital Robert;

    Department of RadiologySection of Interventional Radiology Northwestern Memorial Hospital Robert;

    Department of RadiologySection of Interventional Radiology Northwestern Memorial Hospital Robert;

    Department of RadiologySection of Interventional Radiology Northwestern Memorial Hospital Robert;

    Department of Medicine Division of HepatologyNorthwestern UniversityChicago IL;

    Department of RadiologySection of Interventional Radiology Northwestern Memorial Hospital Robert;

    Department of RadiologySection of Interventional Radiology Northwestern Memorial Hospital Robert;

    Department of RadiologySection of Interventional Radiology Northwestern Memorial Hospital Robert;

    Department of RadiologySection of Interventional Radiology Northwestern Memorial Hospital Robert;

    Department of RadiologySection of Interventional Radiology Northwestern Memorial Hospital Robert;

    Department of RadiologySection of Interventional Radiology Northwestern Memorial Hospital Robert;

    Department of Medicine Division of HepatologyNorthwestern UniversityChicago IL;

    Department of RadiologySection of Interventional Radiology Northwestern Memorial Hospital Robert;

    Department of RadiologySection of Interventional Radiology Northwestern Memorial Hospital Robert;

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  • 正文语种 eng
  • 中图分类 消化系及腹部疾病;
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