Yttrium-90 Radioembolisation versus Transarterial Chemoembolisation for Unresectable Hepatocellular Carcinoma: A Retrospective Comparative Analysis According to BCLC Classification

Marco Massani, Giovanni Pirozzolo, Tommaso Stecca, Davide Barbisan, Franco Dalla Pozza, Giovanni Morana and Nicolo’ Bassi

Department of Surgical Oncology, IV Divisione Chirurgica Centro Regionale per la chirurgia epatobiliopancreatica, Ospedale Regionale Treviso, Italy
Department of Radiology, IV Divisione Chirurgica Centro Regionale per la chirurgia epatobiliopancreatica, Ospedale Regionale Treviso, Italy
Departemnt of Nuclear Medicine, IV Divisione Chirurgica Centro Regionale per la chirurgia epatobiliopancreatica, Ospedale Regionale Treviso, Italy

^*Correspondance to: Marco Massani 

 PDF  Full Text DOI: 10.25107/2474-1647.1528

Abstract

Introduction: Transarterial Chemoembolisation (TACE) and Transarterial Radioembolisation (TARE) are therapeutic options for unresectable hepatocellular carcinoma (HCC). The effectiveness of these procedures has been compared in several retrospective series, but few stratified the results according to the Barcelona Clinic Liver Cancer (BCLC) staging system. The aim of this single centre retrospective study was to compare the effectiveness of TARE and TACE and to evaluate the outcomes according to BCLC stage.Methods: A retrospective analysis of data from a single centre in Italy from 121 consecutive patients with unresectable HCC who underwent TARE (n=39) or TACE (n=82). The primary endpoint was Overall Survival (OS) determined by the Kaplan-Meier method. Further survival analyses by BCLC stage, and a multivariate analysis for other factors affecting survival, were performed.Results: There were no substantial differences in mean or median OS times between the TARE and TACE groups (24.05 vs. 27.39 months, and 21.00 vs. 23.50 months, respectively). Increased OS was observed with TARE versus TACE in patients with BCLC stage B HCC, but there were no differences between treatments in patients with BCLC stage C HCC. At 24 months after the procedure, in patients with BCLC stage B HCC, TARE resulted in significantly greater mean OS time than TACE (21.53±1.61 vs. 17.06±1.50 months, respectively).Conclusion: TARE and TACE were similarly effective; however, subgroup analysis showed an enhanced survival in TARE patients with BCLC stage B disease. Prospective studies with adequate follow-up could further clarify the observed differences, potentially producing objective data to guide treatment in this patient group.

Keywords

Barcelona clinic liver cancer staging; Hepatocellular carcinoma; Overall survival; Transarterial Chemoembolisation; Transarterial radioembolisation

Cite the article

Massani M, Pirozzolo G, Stecca T, Barbisan D, Pozza FD, Morana G, et al. Yttrium-90 Radioembolisation versus Transarterial Chemoembolisation for Unresectable Hepatocellular Carcinoma: A Retrospective Comparative Analysis According to BCLC Classification. Clin Surg. 2017; 2: 1528.