Outcome of transarterial radioembolization in patients with hepatocellular carcinoma as a first line interventional therapy and after previous transarterial chemoembolization

Abstract

Abstract Due to lack of data, there is an ongoing debate regarding the optimal interventional therapy of unresectable hepatocellular carcinoma (HCC). The aim of the study is to compare the results of transarterial radioembolization (TARE) as first-line therapy and after prior transarterial chemoembolization (TACE) in these patients. 83 patients were evaluated. 38 patients received at least one TACE session prior to TARE (27 male; mean age 67.2 years; 68.4% stage BCLC B, 31.6% BCLC C); 45 patients underwent primary TARE (33 male; mean age 69.9 years; 40% BCLC B, 58% BCLC C). Clinical (age, gender, BCLC stage, activity (GBq), Child-Pugh status, portal vein thrombosis, tumor volume), and procedural (overall survival (OS), local tumor control (LTC) and progression-free survival (PFS)) data were compared. Regression analysis was performed to evaluate OS, LTC and PFS. No differences were found in OS (95% CI:1.12, P = 0.289), LTC (95% CI:0.003, P = 0.95) and PFS (95% CI:0.4, P = 0.525). Regression analysis revealed a relationship between Child-Pugh Score (P = 0.005), size of HCC lesions (> 10 cm) (P = 0.022) and OS; neither prior TACE (Child Pugh B patients; 95% CI:0.120, P = 0.729) nor number of lesions (> 10; 95% CI:2.930, P = 0.087) correlated with OS. Prior TACE does not affect outcome of TARE in unresectable HCC.