Morphologic Changes Gauge Liver Cancer Therapy Response-- Jeff Muise
Tuesday, December 1, 2009
TUESDAY, Dec. 1 (HealthDay News) -- A method to assess the effect of chemotherapy on liver tumors based on morphologic changes observed on computed tomography (CT) was found to be significantly associated with pathologic response as well as with patient survival, according to a study in the Dec. 2 Journal of the American Medical Association.
Yun Shin Chun, M.D., of the M.D. Anderson Cancer Center in Houston, and colleagues studied 50 patients who underwent hepatic resection following preoperative chemotherapy, including bevacizumab. CT scans at the start and end of preoperative therapy were assessed by three radiologists for morphologic response, typically a change to homogeneous hypoattenuating lesions with sharp borders. The morphologic response assessments were compared to assessments using the Response Evaluation Criteria in Solid Tumors (RECIST), based on pathologic response (tumor shrinkage). The morphologic criteria were validated in a separate group of 82 similarly-treated patients with inoperable colorectal liver metastases.
The researchers found that the morphologic response correlated with percentages of residual tumor cells in tumor specimens as follows: 20 percent for optimal response, 50 percent for incomplete response, and 70 percent for no response. In the validation group, those with optimal morphologic response had 31 months median survival compared with 19 months with no or incomplete morphologic response. Assessment using RECIST did not correlate with survival in either the group that underwent resection or the validation group.
"Among patients with colorectal liver metastases treated with bevacizumab-containing chemotherapy, CT-based morphologic criteria had a statistically significant association with pathologic response and overall survival," the authors write.
Authors of the study reported financial relationships with the pharmaceutical industry.
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