Transarterial radioembolization versus tyrosine kinase inhibitor in hepatocellular carcinoma with portal vein thrombosisopen access
- Authors
- Haeng, Moon; Chao, Yuri; Kim, Do Young; Lee, Jae Seung; Kim, Gyoung Min; Kim, Hyo-Cheol; Sinn, Dong Hyun; Hyun, Dongho; Lee, Han Ah; Seo, Yeon Seok; Lee, In Joon; Park, Joong-Won; Kim, Yoon Jun
- Issue Date
- Jul-2023
- Publisher
- 대한간학회
- Keywords
- Hepatocellular carcinoma; Portal vein tumor thrombus; Transarterial radioembolization; Sorafenib; Lenvatinib
- Citation
- Clinical and Molecular Hepatology, v.29, no.3, pp 763 - 778
- Pages
- 16
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- Clinical and Molecular Hepatology
- Volume
- 29
- Number
- 3
- Start Page
- 763
- End Page
- 778
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/63984
- DOI
- 10.3350/cmh.2023.0076
- ISSN
- 2287-2728
2287-285X
- Abstract
- Background/Aims: Transarterial radioembolization (TARE) has shown promising results in treating advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). However, whether TARE can provide superior or comparable outcomes to tyrosine kinase inhibitor (TKI) in patients with HCC and PVTT remains unclear. We compared the outcomes of TARE and TKI therapy in treatment-naive patients with locally advanced HCC and segmental or lobar PVTT. Methods: This multicenter study included 216 patients initially treated with TARE (n=124) or TKI (sorafenib or lenvatinib; n=92) between 2011 and 2021. Baseline characteristics were balanced using propensity score matching (PSM) or inverse probability of treatment weighting (IPTW). The primary outcome was overall survival (OS). The secondary outcomes included progression-free survival (PFS) and objective response rate (ORR). Results: In the unmatched cohort, the median OS of the TARE and TKI groups were 28.2 and 7.2 months, respectively (P<0.001), and the TARE group experienced significantly and independently longer OS compared to the TKI group (adjusted hazard ratio=0.41, 95% confidence interval=0.28-0.60, P<0.001). Similar results were observed in the study cohorts balanced with IPTW (P=0.003) or PSM (P=0.004). Although PFS was comparable between the two groups, the TARE group showed a trend of prolonged PFS in a subpopulation of patients with Vp1 or Vp2 PVTT (P=0.052). In the matched cohorts, the ORR of the TARE group was 53.0-56.7%, whereas that of the TKI group was 12.3-15.0%. Conclusions: For patients with advanced HCC with segmental or lobar PVTT and well-preserved liver function, TARE may provide superior OS compared to sorafenib or lenvatinib. (Clin Mol Hepatol 2023;29:763-778)
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Collections - 2. Clinical Science > Department of Gastroenterology and Hepatology > 1. Journal Articles
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