The efficacy, safety, and predictors of outcomes of transarterial radioembolization for hepatocellular carcinoma: a retrospective study.

ABSTRACT

OBJECTIVES: Yttrium-90 transarterial radioembolization (TARE) is a safe, effective modality of locoregional therapy for intermediate and advanced-stage hepatocellular carcinoma (HCC). We aim to identify novel predictors of important outcomes of TARE therapy. METHODS: A single-center retrospective study of 166 patients treated with TARE for HCC at Mayo Clinic Rochester between 2005-2015 and followed until December 2017. Multivariate logistic and stepwise regression analysis models were used to identify variables associated with overall survival (OS) and progression-free survival (PFS). RESULTS: The median OS and the median PFS were12.9  (95% CI 11.0-17.3), and 8 months (95% CI 6-11), respectively. Macrovascular invasion (HR 1.9 [1.3-2.8]), Child-Pugh score (CPS) B or C vs. A (HR 1.8 [1.2-2.7]), Eastern Cooperative Oncology Group Performance status (ECOG-PS) 2 or 1 vs. 0 (HR 1.6 [1.1-2.4]) and activity (A) of administered radiation dose (HR 1.005[1.00-1.010), independently correlated with poorer OS. Infiltrative HCC (HR 2.4 [1.3-4.5), macrovascular invasion (HR 1.6 [1.1-2.7]), and high activity of administered radiation dose (HR 1.005 [1.00-1.010) were associated with worse PFS. CONCLUSION: In HCC patients treated with TARE; macrovascular invasion, the activity of radiation dose, CPS, ECOG-PS, and infiltrative HCC predict OS and PFS.