Radiographic response to locoregional therapy in hepatocellular carcinoma predicts patient survival times

Abstract

Background & Aims: It is not clear whether survival times of patients with hepatocellular carcinoma (HCC) are associated with their response to therapy. We analyzed the association between tumor response and survival times of patients with HCC who were treated with locoregional therapies (LRTs) (chemoembolization and radioembolization). Methods: Patients received LRTs over a 9-year period (n = 463). Patients with metastases, portal venous thrombosis, or who had received transplants were excluded; 159 patients with ChildPugh B7 or lower were analyzed. Response (based on European Association for the Study of the Liver [EASL] and World Health Organization [WHO] criteria) was associated with survival times using the landmark, risk-of-death, and MantelByar methodologies. In a subanalysis, survival times of responders were compared with those of patients with stable disease and progressive disease. Results: Based on 6-month data, in landmark analysis, responders survived longer than nonresponders (based on EASL but not WHO criteria: P =.002 and.0694). The risk of death was also lower for responders (based on EASL but not WHO criteria: P =.0463 and.707). Landmark analysis of 12-month data showed that responders survived longer than nonresponders (P