Choi criteria are superior in evaluating tumor response in patients treated with transarterial radioembolization for hepatocellular carcinoma

Weng,Zhihong; Ertle,Judith; Zheng,Shaoping; Lauenstein,Thomas; Mueller,Stefan; Bockisch,Andreas; Gerken,Guido; Yang,Dongliang; Schlaak,Joerg  F.

doi:10.3892/ol.2013.1612

Choi criteria are superior in evaluating tumor response in patients treated with transarterial radioembolization for hepatocellular carcinoma

Authors:
- Zhihong Weng
- Judith Ertle
- Shaoping Zheng
- Thomas Lauenstein
- Stefan Mueller
- Andreas Bockisch
- Guido Gerken
- Dongliang Yang
- Joerg F. Schlaak
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Affiliations: Department of Gastroenterology and Hepatology, University Hospital of Essen, Essen D‑45122, Germany, Department of Ultrasonography, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China, Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital of Essen, Essen D‑45122, Germany, Institute of Nuclear Medicine, University Hospital of Essen, Essen D‑45122, Germany, Department of Infectious Disease, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
Published online on: October 10, 2013 https://doi.org/10.3892/ol.2013.1612
Pages: 1707-1712

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Abstract

In this study, Response Evaluation Criteria in Solid Tumors (RECIST), modified RECIST (mRECIST), Choi and modified Choi criteria were compared to determine which method is optimal for response evaluation in hepatocellular carcinoma (HCC) patients treated with transarterial radioembolization (TARE) with yttrium‑90 microspheres. Responses were evaluated by RECIST, mRECIST, Choi and modified Choi criteria in 113 patients with HCC undergoing TARE. Results were compared at 12 weeks after therapy. Kaplan‑Meier survival analyses and Cox regression were used to assess differences in time to progression (TTP) and overall survival (OS) between the responders and non‑responders deﬁned by each method. The results demonstrated that the responders and non‑responders defined by mRECIST and Choi criteria successfully identified patients with a long TTP (400 and 280 days) or short TTP (188 and 166 days) (P=0.004 and 0.002, respectively). Neither RECIST nor modified Choi criteria discriminated between patients who had a short or long clinical benefit. Cox regression analysis revealed that Choi response was a prognostic factor of OS (P=0.004) and was associated with a 53% risk reduction. There was no signiﬁcant association between survival and RECIST, mRECIST and modified Choi responses. In conclusion, tumor response according to Choi criteria may be helpful to define early HCC patients who benefit from TARE. RECIST, mRECIST and modified Choi appeared inferior.

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