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Comparison between mRECIST, EASL, and qEASL methods with AFP as tumor response parameters after local chemotherapy in patients with intermediate hepatocellular carcinoma
Wijaya I.G.
Gazzetta Medica Italiana Archivio Per Le Scienze Mediche
Q4Abstract
BACKGROUND: Hepatocellular carcinoma (HCC) is the most common type of liver cancer, ranking as the fifth most prevalent cancer globally and the second leading cause of cancer-related deaths after lung cancer. Risk factors include viral infections, alcoholic and non-alcoholic liver disease, and aflatoxin exposure. HCC diagnosis commonly based on imaging and alpha-fetoprotein (AFP) levels. For patients with unresectable HCC, local chemotherapy may be used to improve quality of life and extend survival rate. This study aims to compare various tumor response parameter methods (mRECIST, EASL, and qEASL) with AFP levels as indicators of therapeutics response following local chemotherapy.METHODS: An analytical observational study with retrospective cross-sectional design was conducted in Makassar from January 2021 to June 2024. Descriptive data were presented as frequencies and percentages, while bivariate analysis using Chi-Square, Spearman, and Pairplot tests conducted to evaluate the relationship between tumor size and AFP levels. Analysis was performed using SPSS v25 software, with a P-value of less than 0.05 indicating statistical significance.RESULTS: A total of 80 samples met the inclusion and exclusion criteria. Findings showed a significant correlation between EASL and qEASL methods with AFP levels (P<0.05), with positive correlation. On the other hand, the qEASL method demonstrated a consistent positive correlation and distribution pattern that matching the AFP levels.CONCLUSIONS: The qEASL method is the most effective and linear approach for assessing tumor response, as it measures active tumor volume which exclude necrotic tissue and lipiodol staining. This method may be valuable in evaluating tumor response in HCC patients receiving local chemotherapy.