Version June 2024
| Response assessment | |
| Target lesions | |
| CR | Disappearance of all target lesions or disappearance of any intratumoral arterial enhancement in all target lesions. |
| PR | At least 30% decrease in the sum of the diameters of viable (enhancing) target lesions, taking as a reference the baseline sum of the diameters of target lesions.* |
| PD | Any increase of at least 20% in the sum of the diameters of viable target lesions, taking as a reference the smallest sum of the diameters of viable (enhancing) target lesions recorded since treatment started.* |
| SD | Any cases that do not qualify for either PR or PD. |
| Non-target lesions | |
| Malignant portal vein thrombosis | Should be considered a nonmeasurable lesion. |
| Lymph nodes | If detected at the porta hepatis, should be considered malignant if the short axis dimension is ≥2.0 cm. |
| Pleural effusions and ascites | Emergence of, or increase in, ascites is common during the course of treatment of a cirrhotic patient, and may reflect worsening of the underlying chronic liver disease and be unrelated to cancer progression. The same is true of pleural effusions. Cytopathologic confirmation of the neoplastic nature of any effusion that appears during treatment is required when the measurable tumor has met criteria for response or SD. |
| New lesions | A newly detected hepatic nodule is classified as hepatocellular carcinoma (and declared evidence of progression) when its longest diameter is at least 1 cm and the nodule has a typical vascular pattern on dynamic imaging (hypervascular in arterial phase with washout in the portal venous or late venous phase). Liver lesions >1 cm that do not show a typical vascular pattern can be diagnosed as hepatocellular carcinoma if there is at least 1 cm internal growth on subsequent scans. |
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