Tumor Size and Watershed Area Correlate with Incomplete Treatment and Tumor Progression after Selective Radioembolization for Hepatocellular Carcinoma.

Autor:	Yu Q; Department of Radiology, University of Chicago Medical Center, University of Chicago, Chicago, Illinois. Electronic address: yuqian1006@gmail.com., Neale M; Department of Radiology, Cleveland Clinic, Cleveland, Ohio., Ungchusri E; Department of Radiology, University of Chicago Medical Center, University of Chicago, Chicago, Illinois., Rothenberger NJ; Department of Urology, University of Washington, Seattle, Washington., Liao C; Department of Public Health Sciences, University of Chicago, Chicago, Illinois., Patel M; Department of Radiology, University of Chicago Medical Center, University of Chicago, Chicago, Illinois., Pillai A; Department of Hepatology, University of Chicago Medical Center, University of Chicago, Chicago, Illinois., Navuluri R; Department of Radiology, University of Chicago Medical Center, University of Chicago, Chicago, Illinois., Ahmed O; Department of Radiology, University of Chicago Medical Center, University of Chicago, Chicago, Illinois., Ha TV; Department of Radiology, University of Chicago Medical Center, University of Chicago, Chicago, Illinois.
Jazyk:	angličtina
Zdroj:	Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2024 May; Vol. 35 (5), pp. 712-721.e3. Date of Electronic Publication: 2024 Feb 07.
DOI:	10.1016/j.jvir.2024.01.031
Abstrakt:	Purpose: To identify factors of incomplete treatment after segmental transarterial radioembolization (TARE) for treatment-naive and solitary hepatocellular carcinoma (HCC). Materials and Methods: A total of 75 consecutive patients (age, 68.5 years [SD ± 8.0]; 25/75 [33.3%] women) with treatment-naive, solitary HCC underwent segmental or subsegmental TARE with glass microspheres (tumor size, 3.8 cm [SD ± 2.2]; administered dose, 222.6 Gy [SD ± 123.9]) at a single institution from November 2015 to June 2022. Radiologic response and progression-free survival (PFS) were assessed as per modified Response Evaluation Criteria in Solid Tumors. Results: Complete treatment was achieved in 48 of 75 (64.0%) patients (mean follow-up, 33.2 months [SD ± 27.4]). Patients with incomplete treatment (27/75, 36%) presented with larger tumor size (5.0 [SD ± 2.5] vs 3.1 [SD ± 1.6] cm; P = .0001), with more tumors located in the watershed zone (81.5% vs 41.7%; P = .001). These patients were less likely to be bridged to transplant or resection (22.2% vs 52.1%; P = .015). Watershed tumors demonstrated worse target tumor PFS (median PFS, 19 months vs not reached; P = .0104) and overall PFS (9.1 months vs not reached; P = .0077). Watershed location was associated with worse PFS among tumors >3 cm in size (8.4 months vs not reached; P = .035) but not in tumors ≤3 cm in size (52.2 months vs not reached; P = .915). Conclusions: Tumor size and watershed location were associated with incomplete treatment after segmental TARE for HCC. Watershed tumors were associated with worse PFS, particularly tumors larger than 3 cm. These tumors may require careful treatment planning and repeated treatments to ensure a durable response. (Copyright © 2024 SIR. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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