Identifier to cite or link to this item: http://hdl.handle.net/20.500.13003/16158
Correlation of RECIST, Computed Tomography Morphological Response, and Pathological Regression in Hepatic Metastasis Secondary to Colorectal Cancer: The AVAMET Study
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AuthorVera, Ruth; Luisa Gomez, Maria; Ramon Ayuso, Juan; Figueras, Joan; Garcia-Alfonso, Pilar; Martinez, Virginia; Lacasta, Adelaida; Ruiz-Casado, Ana; Jose Safont, Maria; Aparicio, Jorge; Manuel Campos, Juan; Carlos Camara, Juan; Martin-Richard, Marta; Montagut, Clara; Pericay, Carles; Maria Vieitez, Jose; Falco, Esther; Jorge, Monica; Marin, Miguel; Salgado, Mercedes; Viudez, Antonio; Spanish Multidisciplinary Grp Dige
Document typeresearch article
CitationVera R, Gomez ML, Ayuso JR, Figueras J, Garcia-Alfonso P, Martinez V, et al. Correlation of RECIST, Computed Tomography Morphological Response, and Pathological Regression in Hepatic Metastasis Secondary to Colorectal Cancer: The AVAMET Study. Cancers. 2020 Aug;12(8):2259.
Background: The prospective phase IV AVAMET study was undertaken to correlate response evaluation criteria in solid tumors (RECIST)-defined response rates with computed tomography-based morphological criteria (CTMC) and pathological response after liver resection of colorectal cancer metastases.Methods: Eligible patients were aged >= 18 years, with Eastern Cooperative Oncology Group (ECOG) performance status 0/1 and histologically-confirmed colon or rectal adenocarcinoma with measurable liver metastases. Preoperative treatment was bevacizumab (7.5 mg on day 1) + XELOX (oxaliplatin 130 mg/m(2), capecitabine 1000 mg/m(2)bid on days 1-14 q3w). After three cycles, response was evaluated by a multidisciplinary team. Patients who were progression-free and metastasectomy candidates received one cycle of XELOX before undergoing surgery 3-5 weeks later, followed by four cycles of bevacizumab + XELOX.Results: A total of 83 patients entered the study; 68 were eligible for RECIST, 67 for CTMC, and 51 for pathological response evaluation. Of these patients, 49% had a complete or partial RECIST response, 91% had an optimal or incomplete CTMC response, and 81% had a complete or major pathological response. CTMC response predicted 37 of 41 pathological responses versus 23 of 41 responses predicted using RECIST (p= 0.008). Kappa coefficients indicated a lack of correlation between the results of RECIST and morphological responses and between morphological and pathological response rates. Conclusion: CTMC may represent a better marker of pathological response to bevacizumab + XELOX than RECIST in patients with potentially-resectable CRC liver metastases.
Keywordsmetastatic colorectal cancer
computed tomography-based morphological criteria