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

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.