Survival analysis of transarterial radioembolization with yttrium-90 for hepatocellular carcinoma patients with HBV infection.

Abstract

INTRODUCTION:

For patients with resectable hepatocellular carcinoma (HCC), hepatectomy remains one of the best treatment options to provide long-term survival. However, more than 50% of the patients have unresectable disease upon diagnosis even though there are no distant metastases. Transarterial chemoembolization (TACE) is a well-established treatment option that offers a palliative survival benefit for this group of patients. A better treatment for unresectable HCC has been sought after. There is some evidence that transarterial radioembolization (TARE) with the agent yttrium-90 produces encouraging outcomes, especially in patients with portal vein tumor thrombus. This study aims to analyze the outcomes of TARE at our center.

METHODS:

From August 2009 to April 2013, 16 patients underwent TARE at our center. Sixteen patients with similar tumor characteristics were selected to undergo TACE alone for comparison. A retrospective analysis of the prospectively collected data of the patients was conducted. Only patients with newly diagnosed primary tumors were included in this study.

RESULTS:

The median survival for patients having TARE was 19.9 versus 14.0 months in the TACE group (P=0.615). There was no difference in terms of tumor response according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) (P=0.632). The 1-, 2- and 3-year survival rates in the TARE group were 80.0%, 30.5% and 20.3% respectively. The 1-year survival in the TACE group was 58.3% (P=0.615). For patients who had major vascular invasion (eight in each group), the 1- and 2-year survival rates in the TARE group were 62.5% and 15.6% respectively, while the 1-year survival in the TACE group was 35.0% (P=0.664).

CONCLUSIONS:

The two groups showed similar results in terms of tumor response and overall survival benefit. TARE might provide a survival benefit for patients with major vessel invasion.

• Authors: Wong Hoi She, Tan To Cheung, Thomas C C Yau, Albert C Y Chan, Kenneth S H Chok, Ferdinand S K Chu, Rico K Y Liu, Ronnie T P Poon, See Ching Chan, Sheung Tat Fan, Chung Mau Lo
• Journal: Hepatobiliary surgery and nutrition (Hepatobiliary Surg Nutr) Vol. 3 Issue 4 Pg. 185-93 (Aug 2014) ISSN: 2304-3881 [Print] China (Republic : 1949- )
• PMID: 25202695 (Publication Type: Journal Article)