Survival in Patients Treated with Trans Arterial Chemo Embolization (TACE) for Unresectable Hepatocellular Carcinoma and Comparison of RECIST, WHO and EASL Criteria in Determining Tumor Response
Notice bibliographique
Résumé
Purpose: This study aims to highlight tumor response and survival in patients with unresectable hepatocellular carcinoma (HCC) receiving TACE and the correlation between RECIST, WHO, and EASL criteria in determining tumor response. Methods: We analyzed retrospectively our outcomes using TACE (doxorubicin and lipiodol) for unresectable HCC in 60 patients who were seen from January 2001 to December 2008. Demographics, presentation, etiology and treatment details were recorded for each patient. Tumors were measured in 1D, 2D and 3D (assuming spherical) and objective tumor response determined using RECIST (1D), WHO (2D) and EASL (tumor necrosis) criteria. Patients were followed until death, transplant, failure of response or treatment failure with maximum follow-up of 7 years. Results: Reporting complete data on 60 patients with 3 patients transplanted immediately post-TACE, 3 died from treatment complications and 1 lost to follow-up. Mean number of TACE per patient was 2.5±1.8 (1-8 interventions). At presentation, mean tumor diameter was 6.9±4.4 cm (1.3-20.4 cm) and 26 patients (43%) were Child-Pugh (CP) A, 25 (42%) were CP B, 1 (1.7%) was CP C and the remaining unknown. The mean MELD score was 8.5±3 points (4-17 points). Tumor response according to RECIST, WHO and EASL criteria are shown in Table 1 and most patients displayed stable disease. Overall mean survival time after first TACE was 20±2.2 months (95% CI, 11.8-26.8). Using WHO classification, mean survival in Partial Response (PR) & Stable Disease (SD) was 20.5±2.4 m (95% CI, 15.7-25.2), and in Progressive Disease (PD) was 16.9±4.4 m (95% CI, 8.4-25.5). Similar results were found using RECIST: PR & SD was 20.9±2.4 m (95% CI, 16.2-25.6), and in PD was 11.8±7.2 m (95% CI, 1.0-25.9); and EASL: PR & SD was 20.5±2.4 m (95% CI, 15.7-25.3), and in PD was 11.8±7.2 m (95% CI, 1.0-25.9). Pearson correlation coefficients between 1D, 2D and 3D measurements and between RECIST, WHO and EASL for tumor response assessment are presented in Table 2. Correlations were equally high between 1D vs. 2D, 1D vs. 3D and 2D vs. 3D measurements and concordance was best between RECIST and WHO and weakest between RECIST and WHO vs. EASL in tumor response assessment.Table 1Table 2Conclusion: TACE prolongs survival and stabilizes tumor growth in patients with unresectable HCC. Survival is better in patients who achieved PR & SD compared to patients who had PD, regardless of the classification used (WHO, RECIST or EASL). There is good concordance between 1D, 2D and 3D measurements of HCC and between RECIST and WHO criteria, but not EASL, in determining tumor response to TACE.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».