English

Abstract

Aim: The aim of the study is to establish tumor response biomarkers in hepatocellular carcinoma
(HCC) patients following Transarterial Chemoembolization (TACE), in order to improve patients’
selection.

Methods: This retrospective study included 47 patients with clinical diagnose of HCC who
underwent TACE between January of 2016 and December of 2017 in a tertiary hospital. The study
time was defined between the last CT before the first TACE performed, and the CT/MRI
performed after the procedure to evaluate tumor response. Population characteristics were recorded
through clinical records, imaging and radiology reports. The diagnostic categories were also
calculated according to the ACR LI-RADS® (Liver Imaging Reporting and Data System) and
treatment response was assessed according to mRECIST (modified Response Evaluation Criteria In
Solid Tumors) criteria.
Results: From 47 patients, 66,0% had early stage HCC (or BCLC-A in Barcelona Clinic Liver
Cancer classification). Thirty-two patients (68,1%) achieved objective response, the sum of
complete response (21,3%) and partial response (46,8%) given by mRECIST. Despite the BCLC-A
category not being associated with complete response after TACE, the subgroup of patients with
small single lesions (<5cm) presents significant association with complete response (P=0.012) as
well as an inferior number of lesions (P=0.001). No other variable showed association with the
tumor response.
Conclusion: Complete response was associated with small single lesions and with an inferior
number of lesions. Further studies with larger cohorts are needed to validate the divergence found
in treatment response among BCLC-A patients and to identify other predictor biomarkers.