Outcomes of Transarterial Hepatic Embolization versus Yttrium-90 Radioembolization for Treatment of Patients with Hepatocellular Carcinoma > 7 cm.

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology Pub Date : 2025-03-13 DOI:10.1016/j.jvir.2025.03.006

Sam Y Son, Sara Velayati, Ken Zhao, Brett Marinelli, Ruben Geevarghese, Vlasios S Sotirchos, Anne Covey, James J Harding, Michael I D'Angelica, William R Jarnagin, Alice Wei, Hooman Yarmohammadi

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引用次数: 0

Abstract

Purpose: To assess safety, and outcomes of transarterial hepatic embolization(TAE) and Yttrium-90 radioembolization (TARE) in treating patients with large (>7cm) hepatocellular carcinoma (HCC).

Methods and materials: Treatment-naive patients with HCC >7cm who were treated with TAE or TARE between January 2013 to 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 mRECIST. Kaplan-Meier survival curves were used to estimate progression-free (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 that were treated with TARE were compared. The mean tumor size was 10.4±2.6cm (TAE) and 10.7±2.7cm (TARE) (p>0.695). TAE and TARE exhibited comparable adverse event rates (Grade 1 AE in 22/44 (50%) in TAE and 6/22 (27%) in TARE; p=0.999; One grade 2 (4.5%)AE in TAE. Median OS was 15.2 and 23.6 months in the TAE and TARE groups, respectively (p=0.252). Median local progression-free survival (LPFS; 4.7 vs 21.6 months, p<0.001) and PFS (3.6 vs 10.0 months, p=0.002) were significantly longer after TARE. TAE and TARE had similar objective response rates (TAE=88.6% vs TARE = 77.3%, p=0.364). Systemic therapy after TAE or TARE was a significant positive prognostic factor associated with disease progression and survival (PFS, HR=0.58, p=0.047; OS, HR=0.33, p<0.001).

Conclusion: 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.

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来源期刊

Journal of Vascular and Interventional Radiology 医学-核医学

CiteScore

4.30

自引率

10.30%

发文量

942

审稿时长

90 days

期刊介绍： JVIR, published continuously since 1990, is an international, monthly peer-reviewed interventional radiology journal. As the official journal of the Society of Interventional Radiology, JVIR is the peer-reviewed journal of choice for interventional radiologists, radiologists, cardiologists, vascular surgeons, neurosurgeons, and other clinicians who seek current and reliable information on every aspect of vascular and interventional radiology. Each issue of JVIR covers critical and cutting-edge medical minimally invasive, clinical, basic research, radiological, pathological, and socioeconomic issues of importance to the field.