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Liver volumetry improves evaluation of treatment response to hepatic artery infusion chemotherapy in uveal melanoma patients with liver metastases Cover

Liver volumetry improves evaluation of treatment response to hepatic artery infusion chemotherapy in uveal melanoma patients with liver metastases

Radiology and Oncology
Volume 58 (2024): Issue 4 (December 2024)
By: ,  ,  ,  ,  ,  ,  ,  ,   and    
Open Access
|Nov 2024
Figures & tables

Figures & Tables

FIGURE 1.

Flowchart of analyzed study population with exclusion criteria.

HAIC = hepatic arterial infusion chemotherapy

FIGURE 2.

Kaplan-Meier curves of overall survival differentiated by change in liver volume of patients with uveal melanoma with liver metastases after first hepatic artery infusion chemotherapy.

TABLE 1.

Comparison of median overall survival (mOS) differentiated by different changes in liver volume before and after first hepatic artery infusion chemotherapy

Liver volume changeLog-rank (Mantel-Cox) test
Increase 0–10%Increase 10–20%Increase > 20%
NmOS [months]Chi-squarepChi-squarepChi-squarep
Decrease5315.90.10.785214.20.000232.3< 0.0001
Increase 0–10%5015.415.8< 0.000133.4< 0.0001
Increase 10–20%257.91.90.162
Increase > 20%155.7
FIGURE 3.

Overall survival of evaluation of treatment response by RECIST 1.1 (A) and liver volumetry with a threshold of 10% (B) of liver volume increase of uveal melanoma patients with liver metastases treated by hepatic artery infusion chemotherapy. Kaplan-Meier curves show overall survival separately for patients evaluated as stable disease (SD) and progressive disease (PD). In liver volumetry, patients with an increase in liver volume more than 10% were classified as PD and with decrease or increase below 10% as SD. RECIST 1.1 criteria as published.19

TABLE 2.

Results of evaluation of treatment response to hepatic artery infusion chemotherapy (HAIC) by RECIST 1.1 and liver volumetry

Before first HAICAfter first HAICp-value
RECIST 1.1a
(Sum of) longest diameter(s) of target lesion(s) [mm]
  Total study cohort (n = 143)48.6 (IQR 36.3–69.2)50.8 (IQR 35.3–76.5)0.0008
  SD (n = 122)47.7 (IQR 36.2–70.5)48.0 (IQR 34.5–71.1)0.3485
  PD (n = 21)55.2 (IQR 34.3–68.9)73.0 (IQR 46.5–85.3)< 0.0001
Liver volumetry
Total liver volume [ml]
  Total study cohort (n = 143)1735 (IQR 1431–2189)1780 (IQR 1461–2329)< 0.0001
  SD (liver volume decreases or increases up to max. 10%) (n=103)1678 (IQR 1426–2176)1714 (IQR 1430–2151)0.6691
  PD (liver volume increases more than 10%) (n=40)1903 (IQR 1481–2529)2203 (IQR 1692–2946)<0.0001

a RECIST 1.1 criteria as published.19 Values are given as median and interquartile range (IQR).

SD = stable disease; PD = progressive disease

FIGURE 4.

Image examples of CT examinations in portal venous phase before and after first hepatic artery infusion chemotherapy (HAIC) for two patients with evaluations according to RECIST 1.1 and liver volumetry (LV) as stable disease (SD) and progressive disease (PD). Liver metastases are marked with arrows.

TABLE 3.

Median overall survival and accordance of treatment response evaluation by RECIST 1.1 and liver volumetry with a threshold of 10% increase in liver volume

Liver volumetry
SD
(Liver volume decreases or increases up to max. 10%)		PD
(Liver volume increases more than 10%)		Total
RECIST 1.1 criteria
SD16.6 months (n = 95)6.6 months (n = 27)14.6 months (n = 122)
PD12.8 months (n = 8)7.7 months (n = 13)8.5 months (n = 21)
Total15.9 months (n = 103)6.6 months (n = 40)12.6 months (n = 143)

[i] Cohen’s κ = 0.289, 95% CI = 0.118–0.461

[ii] SD = stable disease; PD = progressive disease

FIGURE 5.

Kaplan-Meier curves for the combined RECIST 1.1 and liver volumetry (LV) evaluation of treatment response with a threshold of 10% increase in liver volume in uveal melanoma patients with liver metastases treated by hepatic artery infusion chemotherapy.

PD = progressive disease; SD = stable disease.

TABLE 4.

Univariate and multivariate Cox proportional hazards regression model of evaluation of treatment response to hepatic artery infusion chemotherapy by RECIST 1.1 and liver volumetry

AnalysisUnivariateMultivariate
CovariateCategorynMedian OS (95% CI)HR (95% CI)pHR (95% CI)p
RECIST 1.1aSD12214.6 (11.9–17.3)ReferenceReference
PD218.5 (5.5–11.5)2.111.29–3.450.0031.190.92–1.550.184
Liver volumetrySD (liver volume decreases or increases up to max. 10%)10315.9 (12.7–19.1)ReferenceReference
PD (liver volume increases more than 10%)406.6 (4.4–8.8)1.841.51–2.26<0.0011.771.43–2.19< 0.001

a RECIST 1.1 criteria as published.19

HR = hazard ratio; OS = overall survival; PD = progressive disease; SD = stable disease

DOI: https://doi.org/10.2478/raon-2024-0063 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Journal RSS Feed
Language: English
Page range: 509 - 516
Submitted on: Aug 2, 2024
Accepted on: Oct 9, 2024
Published on: Nov 28, 2024
Published by: Association of Radiology and Oncology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
uveal melanoma,
computed tomography,
liver volumetry,
staging
Related subjects:
Medicine,
Clinical medicine,
Radiology

© 2024 Sebastian Zensen, Hannah L Steinberg-Vorhoff, Aleksandar Milosevic, Heike Richly, Jens T Siveke, Marcel Opitz, Johannes Haubold, Yan Li, Michael Forsting, Benedikt Michael Schaarschmidt, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 58 (2024): Issue 4 (December 2024)
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