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Background: Pathological complete response (pCR), in breast cancers, after neoadjuvant chemotherapy is linked to improved survival. Determining complete response to chemotherapy prior to surgery has remained elusive even using a combination of pathological factors and imaging modalities, making surgery still a necessity. Methods: A retrospective analysis was performed from a single institution from 2013 to 2018. Breast cancer patients treated with neoadjuvant chemotherapy with pre‐ and post‐chemotherapy magnetic resonance imaging (MRI) were included. Patients receiving other neoadjuvant modalities were excluded. Imaging characteristics, including response to chemotherapy and pathological factors, were recorded. Results: Analysis showed 134 patients were identified with 40/134 (29.9%) noted to have radiological complete response and 34/134 (25.6%) had pCR. The positive predictive value for MRI to detect pCR was greatest for oestrogen receptor (ER) negative and human epidermal growth factor receptor 2 (HER2) negative tumours at 81.8% and worst for ER+ HER2− tumours at 25%. The negative predictive value was greatest for ER+ HER2− tumours at 93.9% and worst for ER− HER2− tumours at 77.4%. Conclusion: MRI after neoadjuvant chemotherapy for breast cancer even combined with tumour factors is not an accurate predictor of pCR. [ABSTRACT FROM AUTHOR]

Aim: Repeated transarterial chemoembolization (TACE) for intermediate‐stage hepatocellular carcinoma (HCC) eventually leads to either deteriorated hepatic reserve or TACE refractoriness. Switching to molecular targeted agents after TACE requires preservation of hepatic reserve. This study aimed to investigate the predictive factors associated with early deterioration of hepatic reserve by repeated TACE prior to refractoriness. Methods: Ninety‐three patients with intermediate‐stage HCC who underwent TACE as the first‐line treatment and had a Child–Pugh class A hepatic reserve were retrospectively analyzed. The time to Child–Pugh class deterioration (TTCPD), defined as the duration from initial TACE to the diagnosis of Child–Pugh class B or C prior to TACE refractoriness, was assessed. Patients who progressed to TACE refractoriness prior to Child–Pugh class deterioration were censored at TACE refractoriness. Results: The radiological response to initial TACE was assessed as responders and non‐responders in 59 (63.4%) and 34 (36.6%) patients, respectively. The median TTCPD was 40.6 months in all patients. The hepatic reserve in 31 (33.3%) patients deteriorated to Child–Pugh class B or C prior to TACE refractoriness. In the multivariate analysis, non‐response to initial TACE, albumin–bilirubin grade 2, and non‐selective TACE were identified as independent predictors associated with a shortened TTCPD. The TTCPD was significantly shorter in the non‐responders than in the responders to initial TACE (median, 19.6 vs. 55.9 months; P < 0.001). Conclusions: Failure to respond to initial TACE was a predictive factor for early deterioration of hepatic reserve prior to TACE refractoriness in intermediate‐stage HCC patients with repeated TACE. [ABSTRACT FROM AUTHOR]

Background: Magnetic resonance imaging (MRI) is the modality of choice for local staging and response evaluation of Ewing sarcoma (EwS). Aim of this study was to determine the relevance of tumor volume response (TVR) in relation to histological response (HisRes) and survival, in order to evaluate if early modification of chemotherapy might be indicated in patients with inadequate TVR. Methods: Three dimensional (3D)‐tumor volume data at diagnosis, during early induction phase (1‐3 courses of chemotherapy; n = 195) and/or late induction phase (4‐6 courses; n = 175) from 241 localized patients were retrospectively analyzed. A distinction was made between adequate response (reduction ≥67%) and inadequate response (reduction <67% or progression). Correlations between TVR, HisRes, event free survival (EFS), and overall survival (OS) were analyzed using chi‐square tests, log‐rank tests, and the Cox‐regression model. Results: Early adequate TVR, noted in 41% of patients, did not correlate with EFS (P = 0.92) or OS (P = 0.38). During late induction phase 62% of patients showed an adequate TVR. EFS for patients with late adequate TVR was better (78%) than for those with inadequate late TVR (61%) (P = 0.01); OS was 80% and 69% (P = 0.26), respectively. No correlation was found between TVR and HisRes. Multivariate analysis showed that poor HisRes, pelvic location and late inadequate TVR were associated with poor outcome. Conclusions: Early inadequate TVR does not predict adverse outcome; therefore, changing the treatment to second line chemotherapy is not indicated in case of inadequate early TVR. Late adequate TVR and good HisRes correlate with better EFS; patients with late inadequate TVR might benefit from augmented therapy. Early adequate tumor volume response (TVR) does not predict outcome, so modification of chemotherapy in case of an inadequate early TVR may not be justifiable. However, late adequate TVR and poor histological response were independent predictors of adverse outcome; therefore, patients with late‐phase inadequate TVR might benefit from augmented treatment. [ABSTRACT FROM AUTHOR]