Titre
Volumetric Enhancing Tumor Burden at CT to Predict Survival Outcomes in Patients with Neuroendocrine Liver Metastases after Intra-arterial Treatment.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Assouline, J.
Auteure/Auteur
Cannella, R.
Auteure/Auteur
Porrello, G.
Auteure/Auteur
de Mestier, L.
Auteure/Auteur
Dioguardi Burgio, M.
Auteure/Auteur
Raynaud, L.
Auteure/Auteur
Hentic, O.
Auteure/Auteur
Cros, J.
Auteure/Auteur
Tselikas, L.
Auteure/Auteur
Ruszniewski, P.
Auteure/Auteur
Vullierme, M.P.
Auteure/Auteur
Vilgrain, V.
Auteure/Auteur
Duran, R.
Auteure/Auteur
Ronot, M.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
2638-616X
Statut éditorial
Publié
Date de publication
2023-01
Volume
5
Numéro
1
Première page
e220051
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
Purpose To investigate whether liver enhancing tumor burden (LETB) assessed at contrast-enhanced CT indicates early response and helps predict survival outcomes in patients with multifocal neuroendocrine liver metastases (NELM) after intra-arterial treatment. Materials and Methods This retrospective study included patients with NELM who underwent intra-arterial treatment with transarterial embolization (TAE) or chemoembolization (TACE) between April 2006 and December 2018. Tumor response in treated NELM was evaluated by using the Response Evaluation Criteria in Solid Tumors (RECIST) and modified RECIST (mRECIST). LETB was measured as attenuation 2 SDs greater than that of a region of interest in the nontumoral liver parenchyma. Overall survival (OS); time to unTA(C)Eable progression, defined as the time from the initial treatment until the time when intra-arterial treatments were considered technically unfeasible, either not recommended by the multidisciplinary tumor board or until death; and hepatic and whole-body progression-free survival (PFS) were evaluated using multivariable Cox proportional hazards analyses, the Kaplan-Meier method, and log-rank test. Results The study included 119 patients (mean age, 60 years ± 11 [SD]; 61 men) who underwent 161 treatments. A median LETB change of -25.8% best discriminated OS (83 months in responders vs 51 months in nonresponders; P = .02) and whole-body PFS (18 vs 8 months, respectively; P < .001). A -10% LETB change best discriminated time to unTA(C)Eable progression (32 months in responders vs 12 months in nonresponders; P < .001) and hepatic PFS (18 vs 8 months, respectively; P < .001). LETB change remained independently associated with improved OS (hazard ratio [HR], 0.56), time to unTA(C)Eable progression (HR, 0.44), hepatic PFS (HR, 0.42), and whole-body PFS (HR, 0.47) on multivariable analysis. Neither RECIST nor mRECIST helped predict patient outcome. Conclusion Response according to LETB change helped predict survival outcomes in patients with NELM after intra-arterial treatments, with better discrimination than RECIST and mRECIST. Keywords: CT, Chemoembolization, Embolization, Abdomen/GI, Liver Supplemental material is available for this article. © RSNA, 2023.
PID Serval
serval:BIB_E918EFA939AC
PMID
Open Access
Oui
Date de création
2023-01-17T08:39:09.301Z
Date de création dans IRIS
2025-05-21T00:55:25Z
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Nom
rycan.220051.pdf
Version du manuscrit
published
Taille
1.01 MB
Format
Adobe PDF
PID Serval
serval:BIB_E918EFA939AC.P001
URN
urn:nbn:ch:serval-BIB_E918EFA939AC5
Somme de contrôle
(MD5):ddea29ae2b1b3b9f354809847c471eb4