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Predictive factors for complete response of chemoembolization with drug-eluting beads (DEB-TACE) for hepatocellular carcinoma

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Abstract

Objectives

To identify clinical and imaging features associated with complete response (CR) to first session of transarterial chemoembolization (TACE) with drug-eluting beads (DEB) in patients with hepatocellular carcinoma.

Methods

In this prospective historical cohort, 172 patients with 315 tumours who received at least one DEB-TACE from 2007 to 2013 were studied. Imaging response was evaluated according to the modified Response Evaluation Criteria in Solid Tumours (mRECIST). Age, gender, aetiology of cirrhosis, Child and BCLC scores, particles size, location in the liver, size of the tumour, presence of a capsule, hypervascularisation on DSA and CT/MRI scans, and blush extinction were analysed.

Results

After one session of treatment, CR was observed in 36 % of the 315 tumours treated. Nodule size, location in the liver, and complete blush extinction on DSA was statistically correlated to complete response, whereas capsule aspect on imaging and demographic criteria were not. In multivariate analysis only, location in the liver and nodule size were significant features.

Conclusions

Tumour location in the segments 1 and 4 is a pejorative factor for CR, whereas tumour size <5 cm is a positive predictive factor. These criteria could, therefore, be taken into consideration to improve the selection of patients for DEB-TACE.

Key Points

• Literature on predictive factors of complete response after DEB-TACE is under-studied.

• Tumour size <5 cm is associated with complete response.

• Location in segments 1 or 4 is a pejorative factor for response.

• No demographic parameter influences complete response.

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Abbreviations

TACE:

Transarterial chemoembolization

cTACE:

conventional Transarterial chemoembolization

DEB-TACE:

Drug-eluting beads – Transarterial Chemoembolization

DEB-DOX:

Drug-eluting beads – doxorubicin

HCC:

Hepatocellular Carcinoma

BCLC:

Barcelona Clinic Liver Cancer

ECOG:

Eastern Cooperation Oncology Group

mRECIST:

modified Response Evaluation Criteria in Solid Tumours

CR:

Complete response

PR:

Partial response

SD:

Stable disease

PD:

Progressive disease

OR:

Odds ratio

AASLD:

American Association for the Study of Liver Diseases

WHO:

World Health Organization

RFA:

Radiofrequency ablation

DSA:

Digital Subtraction Angiography

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Acknowledgements

The scientific guarantor of this publication is Guillaume Vesselle. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was not required for this study because of the information of implicit acknowledgement for the use of medical data in the patient’s hospital chart. For this reason, written informed consent was waived by the Institutional Review Board. Methodology: prospective, observational, historical cohort, performed at one institution.

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Authors and Affiliations

  1. Diagnostic, Functional and Therapeutic Imaging Department, Poitiers University Hospital, 2 rue de la Milétrie, 86021, Poitiers Cedex, France

    Guillaume Vesselle, Stéphane Velasco, Samy Boucebci & Jean-Pierre Tasu

  2. Department of Gastroenterology, Poitiers University Hospital, 2 rue de la Milétrie, 86021, Poitiers Cedex, France

    Camille Quirier-Leleu, Florian Charier & Christine Silvain

  3. Epidemiology and Biostatistics, Clinical Investigation Center INSERM CIC-P 802, Poitiers University Hospital, 2 rue de la Milétrie, 86021, Poitiers Cedex, France

    Pierre Ingrand

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  1. Guillaume Vesselle
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  2. Camille Quirier-Leleu
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Correspondence to Guillaume Vesselle.

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Vesselle, G., Quirier-Leleu, C., Velasco, S. et al. Predictive factors for complete response of chemoembolization with drug-eluting beads (DEB-TACE) for hepatocellular carcinoma. Eur Radiol 26, 1640–1648 (2016). https://doi.org/10.1007/s00330-015-3982-y

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  • DOI: https://doi.org/10.1007/s00330-015-3982-y

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