• Eun Suk Jung, Ji Hoon Kim, Eileen L Yoon, Hyun Jung Lee, Soon Jae Lee, Sang Jun Suh, Beom Jae Lee, Yeon Seok Seo, Hyung Joon Yim, Tae-Seok Seo, Chang Hee Lee, Jong Eun Yeon, Jong-Jae Park, Jae Seon Kim, Young Tae Bak, and Kwan Soo Byun.
• Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
• J. Hepatol. 2013 Jun 1; 58 (6): 1181-7.

Background & AimsRecently, new methods, including the concept of viable enhancing tumor such as EASL and mRECIST, have been proposed for substitution of the conventional WHO and RECIST criteria in hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). Herein, we evaluated the differences of four methods and compared the association of these methods with the prognosis of HCC patients undergoing TACE.MethodsWe retrospectively reviewed 114 consecutive newly diagnosed HCC patients who underwent TACE as initial treatment. We evaluated the intermethod agreement (κ values) between the methods and compared their association with the prognosis of HCC patients.ResultsThe κ values for EASL vs. WHO, EASL vs. RECIST, mRECIST vs. WHO, and mRECIST vs. RECIST were low, of 0.102, 0.088, 0.112, and 0.122, respectively. However, good correlations were observed for WHO vs. RECIST and EASL vs. mRECIST (κ=0.883, κ=0.759, respectively p<0.001). The median OS was 32.3 months. Hazard ratios (HR) for survival in responders compared with non-responders were 0.21 (95% CI; 0.12-0.37, p<0.001) for EASL and 0.27 (95% CI; 0.15-0.48, p<0.001) for mRECIST. The mean survival of responders was significantly longer than that of non-responders in both EASL (40.8 vs. 16.9 months, p<0.001) and mRECIST (41.1 vs. 20.7 months, p<0.001). In multivariate analysis, EASL response (HR 0.21, 95% CI 0.11-0.40, p<0.001) and mRECIST response (HR; 0.31, 95% CI, 0.17-0.59, p<0.001) were independently associated with survival.ConclusionsThe response assessment by EASL and mRECIST could reliably predict the survival of HCC patients undergoing TACE and could be applicable in practice in preference to the conventional WHO and RECIST criteria.Copyright © 2013 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

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