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

Introduction: For patients with resectable hepatocellular carcinoma (HCC), hepatectomy remains oneof the best treatment options to provide long-term survival. However, more than 50% of the patientshave unresectable disease upon diagnosis even though there are no distant metastases. Transarterialchemoembolization (TACE) is a well-established treatment option that offers a palliative survival benefitfor this group of patients. A better treatment for unresectable HCC has been sought after. There is someevidence that transarterial radioembolization (TARE) with the agent yttrium-90 produces encouragingoutcomes, especially in patients with portal vein tumor thrombus. This study aims to analyze the outcomesof TARE at our center.Methods: From August 2009 to April 2013, 16 patients underwent TARE at our center. Sixteen patientswith similar tumor characteristics were selected to undergo TACE alone for comparison. A retrospectiveanalysis of the prospectively collected data of the patients was conducted. Only patients with newly diagnosedprimary tumors were included in this study.Results: The median survival for patients having TARE was 19.9 versus 14.0 months in the TACEgroup (P=0.615). There was no difference in terms of tumor response according to the modified ResponseEvaluation Criteria in Solid Tumors (mRECIST) (P=0.632). The 1-, 2- and 3-year survival rates in theTARE 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 survivalrates in the TARE group were 62.5% and 15.6% respectively, while the 1-year survival in the TACE groupwas 35.0% (P=0.664).Conclusions: The two groups showed similar results in terms of tumor response and overall survivalbenefit. TARE might provide a survival benefit for patients with major vessel invasion.