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Optimal time point of response assessment for predicting survival is associated with tumor burden in hepatocellular carcinoma receiving repeated transarterial chemoembolization

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机构: [1]Department of Liver Diseases and Interventional Radiology, Digestive Diseases Hospital, Xi’an International Medical Center Hospital, Northwest University, Xi’an, China [2]Department of Liver Disease and Digestive Interventional Radiology, National Clinical Research Center for Digestive Disease and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an, China [3] Department of Medical Affairs, Air Force Hospital of Western Theater Command, Chengdu, Sichuan Province, China [4] Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China [5] Department of Hepatobiliary and Pancreatic Interventional Cancer, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China [6]Department ofMinimally Invasive International Therapy, The Third Affiliated Hospital of Kunming University, Tumor Hospital of Yunnan Province, Kunming, China [7]Department of Interventional Radiology, Jiangsu Provincial Cancer Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China [8]Department of Interventional Radiology, Henan Cancer Hospital, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China [9]Department of Interventional Radiology, The Affiliated Hospital of Nantong University, Nantong, China [10]Department of Gastroenterology and Hepatology, Shandong Province Hospital Affiliated to Shandong University, Jinan, China [11]Department of Hepatobiliary Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, China [12]Department of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, China [13]Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China [14]Department of Interventional Radiology, The Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, China [15]Clinical Liver Diseases Research Center, Nanjing Military Command, 180th Hospital of PLA, Quanzhou, China [16]Department of Interventional Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China [17]Interventional Medical Center of The Affiliated Hospital of Qingdao University, Qingdao, China [18]Department of Interventional Radiology, Sichuan Cancer Hospital & Institute, Chengdu, China [19]Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China [20]State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Disease and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an, China [21]Department of Health Statistics, Fourth Military Medical University, Xi’an, China European Radiology
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关键词: Chemoembolization Tumor burden Carcinoma hepatocellular Surrogate endpoint

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Objectives Objective response rate (ORR) under mRECIST criteria after transarterial chemoembolization (TACE) is a well-perceived surrogate endpoint of overall survival (OS). However, its optimal time point remains controversial and may be influenced by tumor burden. We aim to investigate the surrogacy of initial/best ORR in relation to tumor burden. Methods A total of 1549 eligible treatment-naive patients with unresectable hepatocellular carcinoma (HCC), Child-Pugh score <= 7, and performance status score <= 1 undergoing TACE between January 2010 and May 2016 from 17 academic hospitals were retrospectively analyzed. Based on "six-and-twelve" criteria, tumor burden was graded as low, intermediate, and high if the sum of the maximum tumor diameter and tumor number was <= 6, > 6 but <= 12, and > 12, respectively. Results Both initial and best ORRs interacted with tumor burden. Initial and best ORRs could equivalently predict and correlate with OS in low (adjusted HR, 2.55 and 2.95, respectively, both p < 0.001; R = 0.84, p = 0.035, and R = 0.97, p = 0.002, respectively) and intermediate strata (adjusted HR, 1.81 and 2.22, respectively, both p < 0.001; R = 0.74, p = 0.023, and R = 0.9, p = 0.002, respectively). For high strata, only best ORR exhibited qualified surrogacy (adjusted HR, 2.61, p < 0.001; R = 0.70, p = 0.035), whereas initial ORR was not significant (adjusted HR, 1.08, p = 0.357; R = 0.22, p = 0.54). Conclusions ORR as surrogacy of OS is associated with tumor burden. For patients with low/intermediate tumor burden, initial ORR should be preferred in its early availability upon similar sensitivity, whereas for patients with high tumor burden, best ORR has optimal sensitivity. Timing of OR assessment should be tailored according to tumor burden.

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基金编号: 81172145 81420108020

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出版当年[2022]版:
大类 | 2 区 医学
小类 | 2 区 核医学
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大类 | 2 区 医学
小类 | 2 区 核医学
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出版当年[2022]版:
Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
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Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

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第一作者机构: [1]Department of Liver Diseases and Interventional Radiology, Digestive Diseases Hospital, Xi’an International Medical Center Hospital, Northwest University, Xi’an, China [2]Department of Liver Disease and Digestive Interventional Radiology, National Clinical Research Center for Digestive Disease and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an, China
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通讯机构: [1]Department of Liver Diseases and Interventional Radiology, Digestive Diseases Hospital, Xi’an International Medical Center Hospital, Northwest University, Xi’an, China [2]Department of Liver Disease and Digestive Interventional Radiology, National Clinical Research Center for Digestive Disease and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an, China
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