Early tumor shrinkage and response assessment according to mRECIST predict overall survival in hepatocellular carcinoma patients under sorafenib
Abstract Background The aim of this study was to explore the relationship between follow-up imaging characteristics and overall survival (OS) in advanced hepatocellular carcinoma (HCC) patients under sorafenib treatment. Methods Associations between OS and objective response (OR) by mRECIST or early...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-01-01
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| Series: | Cancer Imaging |
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| Online Access: | https://doi.org/10.1186/s40644-021-00439-x |
| _version_ | 1819228925204627456 |
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| author | Osman Öcal Regina Schinner Kerstin Schütte Enrico N. de Toni Christian Loewe Otto van Delden Vincent Vandecaveye Bernhard Gebauer Christoph J. Zech Christian Sengel Irene Bargellini Antonio Gasbarrini Bruno Sangro Maciej Pech Peter Malfertheiner Jens Ricke Max Seidensticker for the SORAMIC study group |
| author_facet | Osman Öcal Regina Schinner Kerstin Schütte Enrico N. de Toni Christian Loewe Otto van Delden Vincent Vandecaveye Bernhard Gebauer Christoph J. Zech Christian Sengel Irene Bargellini Antonio Gasbarrini Bruno Sangro Maciej Pech Peter Malfertheiner Jens Ricke Max Seidensticker for the SORAMIC study group |
| author_sort | Osman Öcal |
| collection | DOAJ |
| description | Abstract Background The aim of this study was to explore the relationship between follow-up imaging characteristics and overall survival (OS) in advanced hepatocellular carcinoma (HCC) patients under sorafenib treatment. Methods Associations between OS and objective response (OR) by mRECIST or early tumor shrinkage (ETS; ≥20% reduction in enhancing tumor diameter at the first follow-up imaging) were analyzed in HCC patients treated with sorafenib within a multicenter phase II trial (SORAMIC). 115 patients were included in this substudy. The relationship between survival and OR or ETS were explored. Landmark analyses were performed according to OR at fixed time points. Cox proportional hazards models with OR and ETS as a time-dependent covariate were used to compare survival with factors known to influence OS. Results The OR rate was 29.5%. Responders had significantly better OS than non-responders (median 30.3 vs. 11.4 months; HR, 0.38 [95% CI, 0.22–0.63], p < 0.001), and longer progression-free survival (PFS; median 10.1 vs. 4.3 months, p = 0.015). Patients with ETS ≥ 20% had longer OS (median 22.1 vs. 11.4 months, p = 0.002) and PFS (median 8.0 vs. 4.3 months, p = 0.034) than patients with ETS < 20%. Besides OR and ETS, male gender, lower bilirubin and ALBI grade were associated with improved OS in univariate analysis. Separate models of multivariable analysis confirmed OR and ETS as independent predictors of OS. Conclusion OR according to mRECIST and ETS in patients receiving sorafenib treatment are independent prognostic factors for OS. These parameters can be used for assessment of treatment benefit and optimal treatment sequencing in patients with advanced HCC. |
| first_indexed | 2024-12-23T11:05:01Z |
| format | Article |
| id | doaj.art-971541f80cc14c379bd9083efd0fc4b4 |
| institution | Directory Open Access Journal |
| issn | 1470-7330 |
| language | English |
| last_indexed | 2024-12-23T11:05:01Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Cancer Imaging |
| spelling | doaj.art-971541f80cc14c379bd9083efd0fc4b42022-12-21T17:49:30ZengBMCCancer Imaging1470-73302022-01-0122111310.1186/s40644-021-00439-xEarly tumor shrinkage and response assessment according to mRECIST predict overall survival in hepatocellular carcinoma patients under sorafenibOsman Öcal0Regina Schinner1Kerstin Schütte2Enrico N. de Toni3Christian Loewe4Otto van Delden5Vincent Vandecaveye6Bernhard Gebauer7Christoph J. Zech8Christian Sengel9Irene Bargellini10Antonio Gasbarrini11Bruno Sangro12Maciej Pech13Peter Malfertheiner14Jens Ricke15Max Seidensticker16for the SORAMIC study groupDepartment of Radiology, University Hospital, LMU MunichDepartment of Radiology, University Hospital, LMU MunichDepartment of Internal Medicine and Gastroenterology, Niels-Stensen-Kliniken MarienhospitalDepartment of Internal Medicine II, University Hospital, LMU MunichSection of Cardiovascular and Interventional Radiology, Department of Bioimaging and Image-Guided Therapy, Medical University of ViennaDepartment of Radiology and Nuclear Medicine, Academic Medical Center, University of AmsterdamDepartment of Radiology, University Hospitals LeuvenDepartment of Radiology, Charité – University Medicine BerlinRadiology and Nuclear Medicine, University Hospital Basel, University of BaselRadiology Department, Grenoble University HospitalDepartment of Vascular and Interventional Radiology, University Hospital of PisaGastroenterology, Gemelli Foundation, Catholic UniversityLiver Unit, Clínica Universidad de NavarraDepartments of Radiology and Nuclear Medicine, University of MagdeburgDepartment of Internal Medicine II, University Hospital, LMU MunichDepartment of Radiology, University Hospital, LMU MunichDepartment of Radiology, University Hospital, LMU MunichAbstract Background The aim of this study was to explore the relationship between follow-up imaging characteristics and overall survival (OS) in advanced hepatocellular carcinoma (HCC) patients under sorafenib treatment. Methods Associations between OS and objective response (OR) by mRECIST or early tumor shrinkage (ETS; ≥20% reduction in enhancing tumor diameter at the first follow-up imaging) were analyzed in HCC patients treated with sorafenib within a multicenter phase II trial (SORAMIC). 115 patients were included in this substudy. The relationship between survival and OR or ETS were explored. Landmark analyses were performed according to OR at fixed time points. Cox proportional hazards models with OR and ETS as a time-dependent covariate were used to compare survival with factors known to influence OS. Results The OR rate was 29.5%. Responders had significantly better OS than non-responders (median 30.3 vs. 11.4 months; HR, 0.38 [95% CI, 0.22–0.63], p < 0.001), and longer progression-free survival (PFS; median 10.1 vs. 4.3 months, p = 0.015). Patients with ETS ≥ 20% had longer OS (median 22.1 vs. 11.4 months, p = 0.002) and PFS (median 8.0 vs. 4.3 months, p = 0.034) than patients with ETS < 20%. Besides OR and ETS, male gender, lower bilirubin and ALBI grade were associated with improved OS in univariate analysis. Separate models of multivariable analysis confirmed OR and ETS as independent predictors of OS. Conclusion OR according to mRECIST and ETS in patients receiving sorafenib treatment are independent prognostic factors for OS. These parameters can be used for assessment of treatment benefit and optimal treatment sequencing in patients with advanced HCC.https://doi.org/10.1186/s40644-021-00439-xHepatocellular carcinomaSorafenibmRECISTEarly tumor shrinkageObjective response |
| spellingShingle | Osman Öcal Regina Schinner Kerstin Schütte Enrico N. de Toni Christian Loewe Otto van Delden Vincent Vandecaveye Bernhard Gebauer Christoph J. Zech Christian Sengel Irene Bargellini Antonio Gasbarrini Bruno Sangro Maciej Pech Peter Malfertheiner Jens Ricke Max Seidensticker for the SORAMIC study group Early tumor shrinkage and response assessment according to mRECIST predict overall survival in hepatocellular carcinoma patients under sorafenib Cancer Imaging Hepatocellular carcinoma Sorafenib mRECIST Early tumor shrinkage Objective response |
| title | Early tumor shrinkage and response assessment according to mRECIST predict overall survival in hepatocellular carcinoma patients under sorafenib |
| title_full | Early tumor shrinkage and response assessment according to mRECIST predict overall survival in hepatocellular carcinoma patients under sorafenib |
| title_fullStr | Early tumor shrinkage and response assessment according to mRECIST predict overall survival in hepatocellular carcinoma patients under sorafenib |
| title_full_unstemmed | Early tumor shrinkage and response assessment according to mRECIST predict overall survival in hepatocellular carcinoma patients under sorafenib |
| title_short | Early tumor shrinkage and response assessment according to mRECIST predict overall survival in hepatocellular carcinoma patients under sorafenib |
| title_sort | early tumor shrinkage and response assessment according to mrecist predict overall survival in hepatocellular carcinoma patients under sorafenib |
| topic | Hepatocellular carcinoma Sorafenib mRECIST Early tumor shrinkage Objective response |
| url | https://doi.org/10.1186/s40644-021-00439-x |
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