Transarterial chemoembolization versus radioembolization as a treatment option for single large (>5 cm) hepatocellular carcinoma: a retrospective study in South Korea

Objective: To date, there has been no study comparing transarterial chemoembolization (TACE) with transarterial radioembolization (TARE) in these patients, so this study was designed to determine which treatment is more effective and safer between TACE and TARE. Methods: From January 2011 to May 2017, patients who received TACE or TARE as a first-line treatment for single large hepatocellular carcinoma at Severance Hospital were reviewed retrospectively. We compared proportion of transition to curative surgery, response rate, the overall survival (OS), progression free survival (PFS). We also compared side effects, and post-procedure liver function between the two groups. Results: Baseline characteristics between the two groups showed no significant difference. There was no difference in the ratio who underwent radical resection and liver transplantation as follow-up treatment, and in OS and PFS. However, disease control rate at 3month was higher in TARE group (100.0% in TARE group versus 54.5% in TACE group, p = 0.009). And in terms of post-procedural side effects, fever was lower in the TARE group than TACE group (0.0% vs. 76.9%, p < 0.001), and length of hospital stay was shorter in the TARE group (3.79 vs. 5.92 days, p = 0.003). In the post-procedural lab, ALT was significantly lower in the TARE group on the day after the procedure. Conclusion: As a treatment for single large HCC under the same conditions, TARE is similar in terms of survival to TACE, but it is advantageous in terms of response rate and side effects. However, more follow-up studies are needed to increase reliability.