Clinical professor Seoul National University Hospital, Republic of Korea
Purpose: To evaluate the survival outcome of chemoembolization and radioembolization in patients with large single hepatocellular carcinoma (HCC) > 6cm.
Materials and Methods: The institutional review board approved this retrospective single center study, which comprised 215 patients with single nodular HCC ( >6cm) who underwent chemoembolization (n = 101) between 2010 and 2016 or radioembolization (n = 114) between 2017 and 2023. Tumor response was assessed using the modified Response Evaluation Criteria In Solid Tumors (mRECIST). If other treatment modality was added without tumor progression, the best tumor response was assessed just before the addition of the 2nd treatment modality. Local tumor progression-free survival (LTPFS) and overall survival (OS) were obtained by the Kaplan-Meier method, and were compared by the log-rank test.
Results: In terms of best tumor response, chemoembolization group had 40 CR, 58 PR, 1 SD and 2 PD, respectively. Radioembolization group had 32 CR, 67 PR, and 15 SD, respectively. Median LTPFS was 8.8 months (95% CI, 6.8-10.8) for chemoembolization and 25.1 months (95% CI, 8.6-41.6) for radioembolization, respectively. Median OS for chemoembolization was 47.2 months (95% CI, 21.7-72.7). Median OS for radioembolization did not reach, yet. 2 year and 5 year OS rate were 67.3% and 46.4% for chemoembolization, and 87.2% and 71.6% for radioembolization, respectively.
Conclusion: Radioembolization has longer overall survival than chemoembolization in patients with large single unresectable HCC ( >6cm).
