Leandro Cardarelli-Leite1, John Chung2, Darren Klass2, Vladimir Marquez3, Frank Chou2, Stephen Ho2, Henry Walton2, Howard Lim4, Peter Tae Wan Kim5, Anastasia Hadjivassiliou2, David M Liu2. 1. Department of Radiology, Vancouver General Hospital, University of British Columbia, 855 W 12th Ave, JP Pavilion G873, Vancouver, BC, V5Z 1M9, Canada. leandrocleite@gmail.com. 2. Department of Radiology, Vancouver General Hospital, University of British Columbia, 855 W 12th Ave, JP Pavilion G873, Vancouver, BC, V5Z 1M9, Canada. 3. Division of Gastroenterology, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada. 4. British Columbia Cancer Agency, Vancouver, BC, Canada. 5. Department of Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada.
Abstract
PURPOSE: Patients with hepatocellular carcinoma and portal vein tumor thrombus have a poor prognosis and limited therapeutic options. We sought to compare survival, tolerability, and safety in such patients treated with conventional yttrium-90 transarterial radioembolization dosimetric techniques or ablative transarterial radioembolization. MATERIALS AND METHODS: This retrospective, single-center cohort study included patients with hepatocellular carcinoma and right, left, and/or main portal vein tumor thrombus, preserved liver function (Child-Pugh class ≤ B7), and good performance status (Eastern Cooperative Oncology Group score ≤ 1) treated with yttrium-90 microspheres from 2011 to 2018 with ablative intent transarterial radioembolization (A-TARE), or conventional technique (cTARE). Statistical models were used to compare overall survival, post-treatment survival, toxicities, and prognosticators of response. RESULTS: Fifty-seven patients were included (21 [36.8%] ablative and 36 [63.2%] conventional intent). Median overall survival was 15.7 months. Compared to conventional treatment, ablative radioembolization was associated with longer median overall survival (45.3 vs 18.2 months; P = 0.003), longer post-treatment survival (19.1 vs 4.9 months; P = 0.005), a 70% lower risk of death (hazard ratio 0.30; 95% confidence interval, 0.13-0.70; P = 0.005), and improved 4-year survival (53.9% vs 11.2%). Overall survival did not differ significantly between treatment with resin and glass microspheres (27.5 vs 22.2 months; P = 0.62). Acceptable hepatic toxicities were observed after yttrium-90 administration, without statistical differences between the groups. CONCLUSION: In patients with advanced hepatocellular carcinoma and portal vein tumor thrombus, A-TARE is associated with longer survival than cTARE. Neither modality is associated with deleterious effects on liver function.
PURPOSE:Patients with hepatocellular carcinoma and portal vein tumor thrombus have a poor prognosis and limited therapeutic options. We sought to compare survival, tolerability, and safety in such patients treated with conventional yttrium-90 transarterial radioembolization dosimetric techniques or ablative transarterial radioembolization. MATERIALS AND METHODS: This retrospective, single-center cohort study included patients with hepatocellular carcinoma and right, left, and/or main portal vein tumor thrombus, preserved liver function (Child-Pugh class ≤ B7), and good performance status (Eastern Cooperative Oncology Group score ≤ 1) treated with yttrium-90 microspheres from 2011 to 2018 with ablative intent transarterial radioembolization (A-TARE), or conventional technique (cTARE). Statistical models were used to compare overall survival, post-treatment survival, toxicities, and prognosticators of response. RESULTS: Fifty-seven patients were included (21 [36.8%] ablative and 36 [63.2%] conventional intent). Median overall survival was 15.7 months. Compared to conventional treatment, ablative radioembolization was associated with longer median overall survival (45.3 vs 18.2 months; P = 0.003), longer post-treatment survival (19.1 vs 4.9 months; P = 0.005), a 70% lower risk of death (hazard ratio 0.30; 95% confidence interval, 0.13-0.70; P = 0.005), and improved 4-year survival (53.9% vs 11.2%). Overall survival did not differ significantly between treatment with resin and glass microspheres (27.5 vs 22.2 months; P = 0.62). Acceptable hepatic toxicities were observed after yttrium-90 administration, without statistical differences between the groups. CONCLUSION: In patients with advanced hepatocellular carcinoma and portal vein tumor thrombus, A-TARE is associated with longer survival than cTARE. Neither modality is associated with deleterious effects on liver function.
Authors: L Cardarelli-Leite; A Hadjivassiliou; D Klass; J Chung; S G F Ho; H J Lim; P T W Kim; A Mujoomdar; D M Liu Journal: Curr Oncol Date: 2020-11-01 Impact factor: 3.677
Authors: Riad Salem; Siddharth A Padia; Marnix Lam; Carlo Chiesa; Paul Haste; Bruno Sangro; Beau Toskich; Kirk Fowers; Joseph M Herman; S Cheenu Kappadath; Thomas Leung; Daniel Y Sze; Edward Kim; Etienne Garin Journal: Eur J Nucl Med Mol Imaging Date: 2022-09-17 Impact factor: 10.057
Authors: Hugo Levillain; Oreste Bagni; Christophe M Deroose; Arnaud Dieudonné; Silvano Gnesin; Oliver S Grosser; S Cheenu Kappadath; Andrew Kennedy; Nima Kokabi; David M Liu; David C Madoff; Armeen Mahvash; Antonio Martinez de la Cuesta; David C E Ng; Philipp M Paprottka; Cinzia Pettinato; Macarena Rodríguez-Fraile; Riad Salem; Bruno Sangro; Lidia Strigari; Daniel Y Sze; Berlinda J de Wit van der Veen; Patrick Flamen Journal: Eur J Nucl Med Mol Imaging Date: 2021-01-12 Impact factor: 9.236
Authors: Sandi A Kwee; Linda L Wong; Miles M Sato; Jared D Acoba; Young Soo Rho; Avantika Srivastava; Douglas P Landsittel Journal: J Vasc Interv Radiol Date: 2021-07-07 Impact factor: 3.682