1. The efficacy, safety, and predictors of outcomes of transarterial radioembolization for hepatocellular carcinoma: a retrospective study
- Author
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James C. Andrews, Amit Mahipal, Wesam Taha, Lewis R. Roberts, Lyn A Glubranson, Nicha Wongjarupong, Sally Bampoh, Abubaker O. Abdalla, Chad J. Fleming, Kristeen Onyirioha, Mohamed A. Abdallah, Mohamed A. Hassan, Morgan E. Nelson, and Gregory A. Wiseman
- Subjects
Adult ,Male ,Oncology ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Tare weight ,Brachytherapy ,Kaplan-Meier Estimate ,Transarterial Radioembolization ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Overall survival ,Humans ,High activity ,Yttrium Radioisotopes ,Neutrophil to lymphocyte ratio ,Aged ,Retrospective Studies ,Aged, 80 and over ,Venous Thrombosis ,Hepatology ,Portal Vein ,business.industry ,Liver Neoplasms ,Radiation dose ,Gastroenterology ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Embolization, Therapeutic ,Microspheres ,Treatment Outcome ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Female ,030211 gastroenterology & hepatology ,business - 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.
- Published
- 2020
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