Local recurrence following complete radiologic response in patients treated with transarterial chemoembolization for hepatocellular carcinoma

Shamar J Young; Tina S Sanghvi; Sandeep Sharma; Cameron Richardson; Nathan T Rubin; Masters M Richards; Donna D'Souza; Siobhan Flanagan; Jafar Golzarian

doi:10.1016/j.diii.2022.01.006

Local recurrence following complete radiologic response in patients treated with transarterial chemoembolization for hepatocellular carcinoma

Shamar J Young, Tina S Sanghvi, Sandeep Sharma, Cameron Richardson, Nathan T Rubin, Masters M Richards, Donna D'Souza, Siobhan Flanagan, Jafar Golzarian

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Abstract

Purpose: The purpose of this study was to determine the local progression rate and identify factors that may predict local progression, in patients who achieve a complete response (CR) radiologically after undergoing transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). Materials and methods: One-hundred-forty-seven patients, who achieved CR of 224 HCCs after TACE, were retrospectively reviewed. There were 109 men and 38 women with a mean age of 61.6 ± 6.8 (SD) years (range: 45.4–86.9 years). Logistic mixed-effects and Cox regression models were used to evaluate associations between clinical factors and local progression. Results: A total of 75 patients (75/147; 51%) and 99 (99/224,44.2%) lesions showed local progression at a median of 289.5 days (Q1: 125, Q3: 452; range: 51–2245 days). Pre-treatment, international normalization ratio (INR) (1.17 ± 0.15 [SD] vs. 1.25 ± 0.16 [SD]; P <0.001), model for end-stage liver disease (9.4 ± 2.6 [SD] vs. 10.6 ± 3.2 [SD]; P = 0.010) and Child-Pugh score (6 ± 1 [SD] vs. 6.4 ± 1.3 [SD]; P = 0.012) were significantly lower while albumin serum level (3.4 ± 0.62 [SD] vs. 3.22 ± 0.52 [SD]; P = 0.033) was significantly greater in those who showed local progression as compared to those who did not. In terms of local-recurrence free survival, the number of TACE treatments (hazard ratio [HR]: 2.05 [95% CI: 1.57–2.67]; P<0.001), INR (HR: 0.13 [95% CI: 0.03–0.61]; P = 0.010) and type of TACE (P = 0.003) were significant. Patients with local progression on any tumor did not differ from those who did in terms of overall survival (P = 0.072), however, were less likely to be transplanted (20/75, 26.7%) than those who did not (33/72; 36.1%) (P = 0.016). Conclusion: A significant number of patients who achieve CR of HCC after TACE have local progression. This emphasizes the importance of long-term follow up.

Original language	English (US)
Pages (from-to)	143-149
Number of pages	7
Journal	Diagnostic and Interventional Imaging
Volume	103
Issue number	3
DOIs	https://doi.org/10.1016/j.diii.2022.01.006
State	Published - Mar 2022

Bibliographical note

Funding Information:
Research reported in this publication was supported by National Institute of Health grant P30 CA77598 utilizing the Biostatistics and Bioinformatics Core shared resource of the Masonic Cancer Center, University of Minnesota and by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1-TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2022 Société française de radiologie

Keywords

End stage liver disease
Hepatocellular carcinoma
Interventional radiology
Survival studies
Therapeutic chemoembolization

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Young, S. J., Sanghvi, T. S., Sharma, S., Richardson, C., Rubin, N. T., Richards, M. M., D'Souza, D., Flanagan, S., & Golzarian, J. (2022). Local recurrence following complete radiologic response in patients treated with transarterial chemoembolization for hepatocellular carcinoma. Diagnostic and Interventional Imaging, 103(3), 143-149. https://doi.org/10.1016/j.diii.2022.01.006

Young, SJ, Sanghvi, TS , Sharma, S, Richardson, C, Rubin, NT, Richards, MM, D'Souza, D , Flanagan, S & Golzarian, J 2022, 'Local recurrence following complete radiologic response in patients treated with transarterial chemoembolization for hepatocellular carcinoma', Diagnostic and Interventional Imaging, vol. 103, no. 3, pp. 143-149. https://doi.org/10.1016/j.diii.2022.01.006

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title = "Local recurrence following complete radiologic response in patients treated with transarterial chemoembolization for hepatocellular carcinoma",

abstract = "Purpose: The purpose of this study was to determine the local progression rate and identify factors that may predict local progression, in patients who achieve a complete response (CR) radiologically after undergoing transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). Materials and methods: One-hundred-forty-seven patients, who achieved CR of 224 HCCs after TACE, were retrospectively reviewed. There were 109 men and 38 women with a mean age of 61.6 ± 6.8 (SD) years (range: 45.4–86.9 years). Logistic mixed-effects and Cox regression models were used to evaluate associations between clinical factors and local progression. Results: A total of 75 patients (75/147; 51%) and 99 (99/224,44.2%) lesions showed local progression at a median of 289.5 days (Q1: 125, Q3: 452; range: 51–2245 days). Pre-treatment, international normalization ratio (INR) (1.17 ± 0.15 [SD] vs. 1.25 ± 0.16 [SD]; P <0.001), model for end-stage liver disease (9.4 ± 2.6 [SD] vs. 10.6 ± 3.2 [SD]; P = 0.010) and Child-Pugh score (6 ± 1 [SD] vs. 6.4 ± 1.3 [SD]; P = 0.012) were significantly lower while albumin serum level (3.4 ± 0.62 [SD] vs. 3.22 ± 0.52 [SD]; P = 0.033) was significantly greater in those who showed local progression as compared to those who did not. In terms of local-recurrence free survival, the number of TACE treatments (hazard ratio [HR]: 2.05 [95% CI: 1.57–2.67]; P<0.001), INR (HR: 0.13 [95% CI: 0.03–0.61]; P = 0.010) and type of TACE (P = 0.003) were significant. Patients with local progression on any tumor did not differ from those who did in terms of overall survival (P = 0.072), however, were less likely to be transplanted (20/75, 26.7%) than those who did not (33/72; 36.1%) (P = 0.016). Conclusion: A significant number of patients who achieve CR of HCC after TACE have local progression. This emphasizes the importance of long-term follow up.",

keywords = "End stage liver disease, Hepatocellular carcinoma, Interventional radiology, Survival studies, Therapeutic chemoembolization",

author = "Young, {Shamar J} and Sanghvi, {Tina S} and Sandeep Sharma and Cameron Richardson and Rubin, {Nathan T} and Richards, {Masters M} and Donna D'Souza and Siobhan Flanagan and Jafar Golzarian",

note = "Funding Information: Research reported in this publication was supported by National Institute of Health grant P30 CA77598 utilizing the Biostatistics and Bioinformatics Core shared resource of the Masonic Cancer Center, University of Minnesota and by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1-TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Publisher Copyright: {\textcopyright} 2022 Soci{\'e}t{\'e} fran{\c c}aise de radiologie",

year = "2022",

month = mar,

doi = "10.1016/j.diii.2022.01.006",

language = "English (US)",

volume = "103",

pages = "143--149",

journal = "Diagnostic and Interventional Imaging",

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T1 - Local recurrence following complete radiologic response in patients treated with transarterial chemoembolization for hepatocellular carcinoma

AU - Young, Shamar J

AU - Sanghvi, Tina S

AU - Sharma, Sandeep

AU - Richardson, Cameron

AU - Rubin, Nathan T

AU - Richards, Masters M

AU - D'Souza, Donna

AU - Flanagan, Siobhan

AU - Golzarian, Jafar

N1 - Funding Information: Research reported in this publication was supported by National Institute of Health grant P30 CA77598 utilizing the Biostatistics and Bioinformatics Core shared resource of the Masonic Cancer Center, University of Minnesota and by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1-TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Publisher Copyright: © 2022 Société française de radiologie

PY - 2022/3

Y1 - 2022/3

N2 - Purpose: The purpose of this study was to determine the local progression rate and identify factors that may predict local progression, in patients who achieve a complete response (CR) radiologically after undergoing transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). Materials and methods: One-hundred-forty-seven patients, who achieved CR of 224 HCCs after TACE, were retrospectively reviewed. There were 109 men and 38 women with a mean age of 61.6 ± 6.8 (SD) years (range: 45.4–86.9 years). Logistic mixed-effects and Cox regression models were used to evaluate associations between clinical factors and local progression. Results: A total of 75 patients (75/147; 51%) and 99 (99/224,44.2%) lesions showed local progression at a median of 289.5 days (Q1: 125, Q3: 452; range: 51–2245 days). Pre-treatment, international normalization ratio (INR) (1.17 ± 0.15 [SD] vs. 1.25 ± 0.16 [SD]; P <0.001), model for end-stage liver disease (9.4 ± 2.6 [SD] vs. 10.6 ± 3.2 [SD]; P = 0.010) and Child-Pugh score (6 ± 1 [SD] vs. 6.4 ± 1.3 [SD]; P = 0.012) were significantly lower while albumin serum level (3.4 ± 0.62 [SD] vs. 3.22 ± 0.52 [SD]; P = 0.033) was significantly greater in those who showed local progression as compared to those who did not. In terms of local-recurrence free survival, the number of TACE treatments (hazard ratio [HR]: 2.05 [95% CI: 1.57–2.67]; P<0.001), INR (HR: 0.13 [95% CI: 0.03–0.61]; P = 0.010) and type of TACE (P = 0.003) were significant. Patients with local progression on any tumor did not differ from those who did in terms of overall survival (P = 0.072), however, were less likely to be transplanted (20/75, 26.7%) than those who did not (33/72; 36.1%) (P = 0.016). Conclusion: A significant number of patients who achieve CR of HCC after TACE have local progression. This emphasizes the importance of long-term follow up.

AB - Purpose: The purpose of this study was to determine the local progression rate and identify factors that may predict local progression, in patients who achieve a complete response (CR) radiologically after undergoing transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). Materials and methods: One-hundred-forty-seven patients, who achieved CR of 224 HCCs after TACE, were retrospectively reviewed. There were 109 men and 38 women with a mean age of 61.6 ± 6.8 (SD) years (range: 45.4–86.9 years). Logistic mixed-effects and Cox regression models were used to evaluate associations between clinical factors and local progression. Results: A total of 75 patients (75/147; 51%) and 99 (99/224,44.2%) lesions showed local progression at a median of 289.5 days (Q1: 125, Q3: 452; range: 51–2245 days). Pre-treatment, international normalization ratio (INR) (1.17 ± 0.15 [SD] vs. 1.25 ± 0.16 [SD]; P <0.001), model for end-stage liver disease (9.4 ± 2.6 [SD] vs. 10.6 ± 3.2 [SD]; P = 0.010) and Child-Pugh score (6 ± 1 [SD] vs. 6.4 ± 1.3 [SD]; P = 0.012) were significantly lower while albumin serum level (3.4 ± 0.62 [SD] vs. 3.22 ± 0.52 [SD]; P = 0.033) was significantly greater in those who showed local progression as compared to those who did not. In terms of local-recurrence free survival, the number of TACE treatments (hazard ratio [HR]: 2.05 [95% CI: 1.57–2.67]; P<0.001), INR (HR: 0.13 [95% CI: 0.03–0.61]; P = 0.010) and type of TACE (P = 0.003) were significant. Patients with local progression on any tumor did not differ from those who did in terms of overall survival (P = 0.072), however, were less likely to be transplanted (20/75, 26.7%) than those who did not (33/72; 36.1%) (P = 0.016). Conclusion: A significant number of patients who achieve CR of HCC after TACE have local progression. This emphasizes the importance of long-term follow up.

KW - End stage liver disease

KW - Hepatocellular carcinoma

KW - Interventional radiology

KW - Survival studies

KW - Therapeutic chemoembolization

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Local recurrence following complete radiologic response in patients treated with transarterial chemoembolization for hepatocellular carcinoma

Abstract

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Keywords

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UN SDGs

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