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Article summary:
1. This study compared existing response criteria in patients with hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE) using a 3D quantitative approach.
2. The study found that three-dimensional (3D) quantitative methods of the index tumor, such as volumetric RECIST (vRECIST) and quantitative EASL (qEASL), were better at predicting patient survival after initial TACE than non-three-dimensional methods such as Response Evaluation Criteria in Solid Tumors (RECIST), European Association for Study of the Liver (EASL), and modified RECIST (mRECIST).
3. The 3D-based imaging biomarkers qEASL and vRECIST enabled clear identification of nonresponders and could be used to predict patient survival early after initial TACE.
Article analysis:
This article is generally reliable, as it is based on a retrospective single-institution HIPAA-compliant and institutional review board-approved study. The authors have provided detailed information about the methodology used, including the number of participants, their demographic characteristics, the response assessment methods used, and the statistical analysis performed. Furthermore, they have provided evidence to support their claims by citing relevant studies in the literature.
However, there are some potential biases that should be noted. First, since this was a retrospective study, it may be subject to recall bias or selection bias due to its reliance on existing data rather than primary data collection. Second, since only 78 treatment-naïve patients with HCC were included in this study, it may not be representative of all patients with HCC who undergo TACE treatment. Third, since this was a single institution study conducted at one hospital over a seven year period from 2001 to 2008, its results may not be generalizable to other settings or time periods. Finally, there is no discussion of possible risks associated with TACE treatment or any potential side effects that patients may experience as a result of undergoing this procedure.