Measuring tumor response and shape change on CT: Esophageal cancer as a paradigm Journal Article


Authors: Schwartz, L. H.; Colville, J. A. C.; Ginsberg, M. S.; Wang, L.; Mazumdar, M.; Kalaigian, J.; Hricak, H.; Ilson, D.; Schwartz, G. K.
Article Title: Measuring tumor response and shape change on CT: Esophageal cancer as a paradigm
Abstract: Background: Accurate response assessment is essential for evaluating new cancer treatments. We evaluated the impact of Response Evaluation Criteria in Solid Tumors (RECIST), World Health Organization (WHO) criteria and tumor shape on response assessment in patients with metastatic esophageal cancer. Patients and methods: In 19 patients with metastatic esophageal cancer in a phase II trial of bryostatin-1 and paclitaxel, response was retrospectively assessed for 89 lesions with RECIST and WHO criteria on baseline and serial follow-up CT scans. The eccentricity factor (EF) was introduced for measuring the degree to which tumor shape diverges from a perfect sphere [EF = √1-(LPD/MD)2, where LPD is the largest perpendicular diameter and MD is the maximal diameter]. Results: The disagreement rate in best overall response categorization between RECIST (unidimensional) and WHO (bidimensional) criteria was 26.3%. Change in eccentricity was significantly greater (P < 0.01) for patients with disagreement (mean 0.31, range 0-0.91). When the short axis was used for unidimensional lymph node measurement, disagreement between WHO and RECIST lessened. Conclusions: Response assessment by WHO and RECIST differs substantially. Greater change in eccentricity is associated with greater discordance between WHO and RECIST. The discordance between WHO and RECIST may impact on how effective a therapy is judged to be. © 2006 Oxford University Press.
Keywords: adult; clinical article; treatment outcome; treatment response; aged; middle aged; retrospective studies; clinical trial; paclitaxel; follow up; follow-up studies; lymphatic metastasis; neoplasm staging; diagnostic accuracy; neoplasms; metastasis; computer assisted tomography; phase 2 clinical trial; image analysis; tumor volume; antineoplastic combined chemotherapy protocols; tomography, x-ray computed; statistical significance; diagnostic value; recist; world health organization; esophagus cancer; bryostatin 1; response criteria; lymphadenopathy; esophageal neoplasms; esophageal cancer; clinical assessment tool; macrolides
Journal Title: Annals of Oncology
Volume: 17
Issue: 6
ISSN: 0923-7534
Publisher: Oxford University Press  
Date Published: 2006-06-01
Start Page: 1018
End Page: 1023
Language: English
DOI: 10.1093/annonc/mdl058
PUBMED: 16641170
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 17" - "Export Date: 4 June 2012" - "CODEN: ANONE" - "Source: Scopus"
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MSK Authors
  1. Gary Schwartz
    364 Schwartz
  2. Michelle S Ginsberg
    158 Ginsberg
  3. Madhu Mazumdar
    123 Mazumdar
  4. Lawrence H Schwartz
    281 Schwartz
  5. Hedvig Hricak
    330 Hricak
  6. Liang Wang
    35 Wang
  7. David H Ilson
    274 Ilson