Outcomes of Transarterial Hepatic Embolization versus Yttrium-90 Radioembolization for Treatment of Patients with Hepatocellular Carcinoma >7 cm Journal Article
| Authors: | Son, S. Y.; Velayati, S.; Zhao, K.; Marinelli, B.; Geevarghese, R.; Sotirchos, V. S.; Covey, A.; Harding, J. J.; D'Angelica, M. I.; Jarnagin, W. R.; Wei, A.; Yarmohammadi, H. |
| Article Title: | Outcomes of Transarterial Hepatic Embolization versus Yttrium-90 Radioembolization for Treatment of Patients with Hepatocellular Carcinoma >7 cm |
| Abstract: | Purpose: To assess and compare the safety, effectiveness, and outcomes of transarterial hepatic embolization (TAE) and transarterial radioembolization (TARE) for the treatment of patients with unresectable hepatocellular carcinoma (HCC) >7 cm. Materials and Methods: Treatment-naive patients with HCC >7 cm who were treated with TAE or TARE between January 2013 and December 2023 were reviewed in this retrospective study. Nearest neighbor 2:1 propensity score matching was utilized for direct comparison. Radiological treatment response was assessed using the modified Response Evaluation Criteria in Solid Tumours (mRECIST). Kaplan-Meier survival curves were used to estimate progression-free survival (PFS) and overall survival (OS). Log-rank tests were performed to compare survival curves. Results: A total of 125 patients with HCC >7 cm were treated with TAE (n = 103) or TARE (n = 22). After propensity score matching, 44 patients who underwent TAE and 22 patients who were treated with TARE were compared. The mean tumor sizes were 10.4 cm (SD ± 2.6) in the TAE group and 10.7 cm (SD ± 2.7) in the TARE group (P >.695). TAE and TARE exhibited comparable adverse event (AE) rates (Grade 1 AE in 22 [50%] of 44 in TAE and 6 [27%] of 22 in TARE, P =.999; 1 Grade 2 AE [4.5%] in TAE). Median OS durations were 15.2 and 23.6 months in the TAE and TARE groups, respectively (P =.252). Median local PFS (4.7 vs 21.6 months, P <.001) and PFS (3.6 vs 10.0 months, P =.002) were significantly longer after TARE. TAE and TARE had similar objective response rates (TAE, 88.6% vs TARE, 77.3%; P =.364). Systemic therapy after TAE or TARE was a significant positive prognostic factor associated with freedom from disease progression and survival (PFS hazard ratio [HR], 0.58 [P =.047]; OS HR, 0.33 [P <.001]). Conclusions: TAE and TARE are both safe transarterial therapies for patients with HCC >7 cm. TARE is associated with a longer time to progression and longer OS. © 2025 SIR |
| Keywords: | adult; treatment response; aged; major clinical study; overall survival; liver cell carcinoma; systemic therapy; cancer staging; biological marker; progression free survival; tumor volume; retrospective study; cancer size; disease free interval; hazard ratio; kaplan meier method; yttrium 90; propensity score; radioembolization; arterial embolization; response evaluation criteria in solid tumors; human; male; female; article; transarterial hepatic embolization; local progression free survival |
| Journal Title: | Journal of Vascular and Interventional Radiology |
| Volume: | 36 |
| Issue: | 7 |
| ISSN: | 1051-0443 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2025-01-01 |
| Start Page: | 1160 |
| End Page: | 1170 |
| Language: | English |
| DOI: | 10.1016/j.jvir.2025.03.006 |
| PUBMED: | 40089103 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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