AccScience Publishing / CP / Online First / DOI: 10.36922/CP025440070
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ORIGINAL RESEARCH ARTICLE

Quartile deviation as a novel indicator of response evaluation regularity in liver cancer patients

Runkai Zhou1† ,  Rongze Sun2† ,  Jingyi Zhou2 ,  Dongyun Gao3† ,  Xuefeng Zhou3* ,  Qi Li2*
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1 Department of General Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
2 Department of Oncology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
3 Department of Oncology, The Dongtai Hospital of Nantong University, Dongtai, Jiangsu, China
†These authors contributed equally to this work.
CP, 025440070 https://doi.org/10.36922/CP025440070
Received: 28 October 2025 | Revised: 5 January 2026 | Accepted: 26 February 2026 | Published online: 5 May 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Regular response evaluation (RE) is essential for whole-process cancer management, yet no standardized quantitative indicator exists to assess its regularity in clinical practice. This study proposed the quartile deviation (QD) of RE intervals as a novel indicator of RE regularity and examined its association with clinical characteristics and survival outcomes in patients with liver tumor lesions. Clinical data from patients treated at Shanghai General Hospital between January 1, 2015, and December 31, 2021, were retrospectively analyzed. A total of 102 eligible patients with at least four upper abdominal computed tomography or magnetic resonance imaging examinations were included, yielding 587 valid RE records; 60.8% completed seven or more REs during treatment. QD values of RE intervals were calculated to assess voluntary RE regularity. Using the mean QD value (6.77) as the cut-off, patients were classified into a regular RE group (QD ≤ 6.77, n = 67) and an irregular RE group (QD > 6.77, n = 35). Patients with regular RE were younger (61.6 ± 1.218 years), had significantly shorter RE intervals (10.57 ± 0.4566 weeks), and achieved a longer median overall survival (39 versus 30 months) than those with irregular RE. Median progression-free survival did not differ significantly between groups. Patients with metastatic colorectal cancer exhibited lower QD values than those with hepatocellular carcinoma, indicating better RE regularity. In conclusion, QD is a practical indicator of RE regularity. More regular RE is associated with improved survival outcomes, supporting standardized cancer management.

Graphical abstract
Keywords
Response evaluation
Liver cancer
Regularity
Quartile deviation
Survival outcomes
Funding
This study was supported by the Clinical Medicine Scientific Research Fund Project of Nantong University (grant no.: 2024LY015 to Xuefeng Zhou).
Conflict of interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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Cancer Plus, Electronic ISSN: 2661-3840 Print ISSN: 2661-3832, Published by AccScience Publishing
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