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

Kim, Jihye; Kim, Ju Yeon; Lee, Jeong-Hoon; Sinn, Dong Hyun; Hur, Moon Haeng; Hong, Ji Hoon; Park, Min Kyung; Cho, Hee Jin; Choi, Narak; Lee, Yun Bin; Cho, Eun Ju; Yu, Su Jong; Kim, Yoon Jun; Paeng, Jin Chul; Kim, Hyo Cheol; Yi, Nam‐Joon; Lee, Kwang‐Woong; Suh, Kyung‐Suk; Hyun, Dongho; Kim, Jong Man; Yoon, Jung‐Hwan

doi:10.2967/jnumed.121.263147

“…640 According to a retrospective cohort study of patients with a single HCC sized ≥5 cm at two Korean centers, 90 Y TARE showed similar OS and PFS compared to hepatic resection, with fewer side effects and superior safety. 641 Therefore, 90 Y TARE, like TACE, can minimize liver damage and maximize the therapeutic efficacy when the procedure is selectively performed through the tumor-feeding artery. Further studies are needed to select appropriate patients and to compare 90 Y TARE with other treatments.…”

Section: Tare Using 90 Y Microspheresmentioning

confidence: 99%

2022 KLCA-NCC Korea practice guidelines for the management of hepatocellular carcinoma

2022

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Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the fourth most common cancer among men in South Korea, where the prevalence of chronic hepatitis B infection is high in middle and old age. The current practice guidelines will provide useful and sensible advice for the clinical management of patients with HCC. A total of 49 experts in the fields of hepatology, oncology, surgery, radiology, and radiation oncology from the Korean Liver Cancer Association-National Cancer Center Korea Practice Guideline Revision Committee revised the 2018 Korean guidelines and developed new recommendations that integrate the most up-to-date research findings and expert opinions. These guidelines provide useful information and direction for all clinicians, trainees, and researchers in the diagnosis and treatment of HCC.

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“…In a Korean single-center study of 90 Y TARE with over 150 Gy delivered to ≥ 5 cm HCC, the complete remission rate was 80% [ 640 ]. According to a retrospective cohort study of patients with a single HCC sized ≥ 5 cm at two Korean centers, 90 Y TARE showed similar OS and PFS compared to hepatic resection, with fewer side effects and superior safety [ 641 ]. Therefore, 90 Y TARE, like TACE, can minimize liver damage and maximize the therapeutic efficacy when the procedure is selectively performed through the tumor-feeding artery.…”

Section: Tace and Radioembolizationmentioning

confidence: 99%

2022 KLCA-NCC Korea Practice Guidelines for the Management of Hepatocellular Carcinoma

2022

View full text Add to dashboard Cite

Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the fourth most common cancer among men in South Korea, where the prevalence of chronic hepatitis B infection is high in middle and old age. The current practice guidelines will provide useful and sensible advice for the clinical management of patients with HCC. A total of 49 experts in the fields of hepatology, oncology, surgery, radiology, and radiation oncology from the Korean Liver Cancer Association-National Cancer Center Korea Practice Guideline Revision Committee revised the 2018 Korean guidelines and developed new recommendations that integrate the most up-to-date research findings and expert opinions. These guidelines provide useful information and direction for all clinicians, trainees, and researchers in the diagnosis and treatment of HCC.

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“… 7 The larger the tumor, the greater the possibility of vascular invasion and the worse the histological differentiation. 8 Even after radical resection, the 5-year disease-free survival rate is still low. 9 Therefore, this study retrospectively analyzed the clinicopathological and prognostic data of patients with SLHCC who underwent radical surgical resection.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Analysis of Single Large Hepatocellular Carcinoma Following Radical Resection: A Single-Center Study

Huang¹,

Li²,

Liu³

et al. 2023

JHC

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Objective To investigate the survival and independent prognostic factors for single large hepatocellular carcinoma (SLHCC) after surgical resection. Methods Patients with SLHCC who underwent radical resection from January 2013 to December 2017 were retrospectively analyzed. The Kaplan-Meier method was used to analyze the overall survival (OS) rate and recurrence-free survival (RFS) rates. Cox forward stepwise regression was performed to analyze the independent prognostic factors. Results A total of 485 cases were included. The average age was 51.2±11.2 years, 88.9% had a history of hepatitis B virus infection, and most patients had normal liver function. The average tumor diameter was 8.8±3.0 cm. The 1-, 3-, and 5-year OS and RFS rates were 76.8%, 56.7%, and 45.7%, and 61.0%, 46.2%, and 34.7%, respectively. Multivariate analysis showed that liver cirrhosis (HR=1.456, P =0.004), total bilirubin (TB) ≥17.1 μmol/L (HR=1.437, P =0.011), glutamyl transferase (GGT) >60 U/L (HR=1.438, P =0.020), lactate dehydrogenase (LDH) >225 U/L (HR=1.442, P =0.007), blood loss ≥400 mL (HR=1.339, P =0.027), microvascular invasion (MVI) (HR=1.492, P =0.004), satellite lesions (HR=1.859, P <0.0001) and Edmondson-Steiner grade III+IV (HR=1.740, P =0.018) were independent risk factors for reduced OS in SLHCC patients. Sex (HR=1.763, P =0.003), liver cirrhosis (HR=1.382, P =0.007), GGT >60 U/L (HR=1.512, P =0.003), LDH >225 U/L (HR=1.480, P =0.002), MVI (HR=1.545, P =0.001), and satellite lesions (HR=1.564, P =0.001) were independent risk factors for reduced RFS. OS and RFS nomograms were constructed using risk factors with C-index values of 0.692 (95% CI: 0.659–0.724) and 0.659 (95% CI: 0.623–0.693), respectively. The Hosmer-Leme test demonstrated the good fit of both nomograms. Conclusion Surgical resection is the standard and effective treatment for SLHCC patients. Sex, liver cirrhosis, TB≥17.1 μmol/L, GGT>60 U/L, LDH>225 U/L, blood loss≥400 mL, MVI, Edmondson-Steiner grade III+IV, and satellite lesions were found to be independent prognostic factors in SLHCC patients following radical resection. The OS and RFS nomograms accurately predicted the prognosis of SLHCC patients.

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

Cited by 19 publications

References 46 publications

2022 KLCA-NCC Korea practice guidelines for the management of hepatocellular carcinoma

2022 KLCA-NCC Korea practice guidelines for the management of hepatocellular carcinoma

2022 KLCA-NCC Korea Practice Guidelines for the Management of Hepatocellular Carcinoma

Prognostic Analysis of Single Large Hepatocellular Carcinoma Following Radical Resection: A Single-Center Study

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