Comparing RECIST with EORTC criteria in metastatic bladder cancer
- 253 Downloads
To compare RECIST and EORTC criteria in an evaluation of response to therapy in metastatic bladder cancer and to assess their influence on decisions to administer additional therapy.
Materials and methods
A total of 42 untreated patients (38 male, 4 female) with metastatic bladder cancer were included in the study, which took place between July 2007 and April 2013. The mean age was 66.1 ± 9.93 years (range 41–84 years). A total of 144 metastatic foci were evaluated using multislice CT and 18FDG-PET/CT before and after first-line chemotherapy. The locations, sizes, numbers and SUVmax of the metastatic foci before and after chemotherapy were recorded, and the response to therapy was evaluated separately using RECIST and EORTC criteria, after which a statistical comparison was made.
According to the RECIST and EORTC criteria, the rate of complete remission (CR) was 9.5 and 16.6 %, the rate of partial remission (PR) was 28.6 and 40.5 %, the rate of stable disease (SD) was 23.8 and 14.3 %, and the rate of progressive disease (PD) was 31.0 and 28.6 %, respectively. The overall response rate (ORR) was 38.1 versus 57.1 %, respectively, and there were no differences between the two criteria in terms of their detection of progressive disease. The rate of SD was higher with RECIST criteria; however, the difference between the two criteria was not significant in terms of PR and CR.
A group of patients that had been determined as having a SD according to RECIST criteria were grouped as PR and/or CR according to EORTC criteria. Additional chemotherapy protocols can be used in second-line chemotherapy and/or cisplatin-resistant patients, according to RECIST criteria. In evaluating the response to first-line chemotherapy for metastatic bladder cancer, EORTC criteria, using 18FDG-PET/CT scans, can be considered as a more applicable and accurate diagnostic tool. The anatomical findings obtained through imaging methods and from functional/metabolic data obtained by PET/CT can be useful in the planning of second- or third-line chemotherapy, and a high accuracy in re-staging can spare patients from second-line or even third-line chemotherapy.
KeywordsMetastatic bladder cancer Chemotheraphy Response to chemotheraphy RECIST EORTC PET/CT
Compliance with ethical standards
Conflict of interest
The authors declare that they have no competing interests. Financial support has not been received.
- Bellmunt J, Choueiri TK, Fougeray R, Schutz FA, Salhi Y, Winquist E et al (2010) Prognostic factors in patients with advanced transitional cell carcinoma of the urothelial tract experiencing treatment failure with platinum-containing regimens. J Clin Oncol 28(11):1850–1855 (Epub 2010 Mar 15) PubMedCrossRefGoogle Scholar
- Heidenreich A, Albers P, Classen J, Graefen M, Gschwend J, Kotzerke J et al (2010) Imaging studies in metastatic urogenital cancer patients undergoing systemic therapy: recommendations of a multidisciplinary consensus meeting of the Association of Urological Oncology of the German Cancer Society. Urol Int 85(1):1–10. doi: 10.1159/000318985 (Epub 2010 Jul 26) PubMedCrossRefGoogle Scholar
- Jensen TK, Holt P, Gerke O, Riehmann M, Svolgaard B et al (2011) Preoperative lymph-node staging of invasive urothelial bladder cancer with 18F-fluorodeoxyglucose positron emission tomography/computed axial tomography and magnetic resonance imaging: correlation with histopathology. Scand J Urol Nephrol 45:122–128PubMedCrossRefGoogle Scholar
- Mertens LS, Mir MC, Scott AM, Lee ST, Fioole-Bruining A, Vegt E et al (2014) 18F-fluorodeoxyglucose-positron emission tomography/computed tomography aids staging and predicts mortality in patients with muscle-invasive bladder cancer. Urology 83(2):393–398. doi: 10.1016/j.urology.2013.10.032 PubMedCrossRefGoogle Scholar