Comparison between modified RECIST and WHO criteria for assessment of hepatocellular carcinoma

In 2010, modified RECIST (mRECIST) criteria were presented to address the unique characteristics of hepatocellular carcinoma (HCC). Our goal was to compare mRECIST and WHO criteria in the treatment response after local and systemic therapies. Additionally, we aimed to improve the assessment of progression, which could be misinterpreted by conventional RECIST 1.1 and WHO criteria due to clinical events associated with chronic liver disease progression (e.g., ascites, lymph node enlargement). mRECIST has been used in clinical practice guidelines for managing HCC in Europe, America, and Asia. Today, mRECIST is the standard tool for assessing responses in the early and middle stages of HCC. We used both methods ( mRECIST and WHO criteria) in assessment of the same patients with hepatocellular carcinoma and then compared the results with post treatment level of alpha fetoprotein (AFP). We concluded that mRECIST is a reliable, applicable and preferable in tumor response assessment of HCC.