Long-Term Outcomes of Transarterial Radioembolization for Large Single Hepatocellular Carcinoma: A Comparison to Resection

The Journal of Nuclear Medicine

article

Hyo Cheol Kim¹  Nam-Joon Yi²  Kwang-Woong Lee²  Kyung-Suk Suh²  Dongho Hyun³  Jong Man Kim⁴  Jung-Hwan Yoon⁵  Jihye Kim⁵  Ju Yeon Kim⁵  Jeong-Hoon Lee⁵  Dong Hyun Sinn⁶  Moon Haeng Hur⁵  Ji Hoon Hong⁵  Min Kyung Park⁵  Hee Jin Cho⁵  Na Ryung Choi⁵  Yun Bin Lee⁵  Eun Ju Cho⁵  Su Jong Yu⁵  Yoon Jun Kim⁵  Jin Chul Paeng⁷ 

[1] Department of Radiology, Seoul National University College of Medicine;Department of Surgery, Seoul National University College of Medicine;Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine;Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine;Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine;Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine;Department of Nuclear Medicine, Seoul National University College of Medicine

关键词: liver cancer;    overall survival;    time to progression;    safety;    initial treatment;   

DOI  :  10.2967/jnumed.121.263147

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

The surgical treatment for large hepatocellular carcinoma (HCC) remains controversial because of a high risk of recurrence after resection. This study aimed to compare long-term outcomes of transarterial radioembolization (TARE) with resection for patients with large HCC. Methods: This retrospective cohort study included 557 patients who were initially treated with either resection (n = 500) or TARE (n = 57) for large (≥5 cm), single nodular HCC at 2 tertiary centers in Korea. Patients with major portal vein tumor thrombosis or extrahepatic metastasis were excluded. The primary endpoint was overall survival (OS), and secondary endpoints were time to progression (TTP), time to intrahepatic progression (TTIP), and safety. Results: The resection group was younger (median, 60 vs. 69 y) and had a smaller tumor size (median, 7.0 vs. 10.0 cm) (all P < 0.05). After baseline characteristics were balanced using inverse-probability-of-treatment weighting, the OS (hazard ratio [HR], 0.98; 95% CI, 0.40–2.43; P = 0.97), TTP (HR, 1.10; 95% CI, 0.55–2.20; P = 0.80), and TTIP (HR, 1.45; 95% CI, 0.72–2.93; P = 0.30) of the TARE group was comparable to the resection group. TARE was not an independent risk for OS (adjusted HR, 1.04; 95% CI, 0.42–2.59; P = 0.93), TTP (adjusted HR, 0.98; 95% CI, 0.50–1.95; P = 0.96), or TTIP (adjusted HR, 1.30; 95% CI, 0.65–2.58; P = 0.46). The TARE group had a shorter hospital stay and fewer adverse events than the resection group. Conclusion: Compared with surgical resection for large single nodular HCC, TARE showed a comparable OS, TTP, and TTIP and a better safety profile.

【 授权许可】

CC BY