title: Survival analysis of transarterial radioembolization with yttrium-90 for hepatocellular carcinoma patients with HBV infection.
abstract: BACKGROUND
  For patients with resectable hepatocellular carcinoma (HCC), hepatectomy remains one of the best treatment options to provide long-term survival. However, more than 50% of the patients have unresectable disease upon diagnosis even though there are no distant metastases. Transarterial chemoembolization (TACE) is a well-established treatment option that offers a palliative survival benefit for this group of patients. A better treatment for unresectable HCC has been sought after. There is some evidence that transarterial radioembolization (TARE) with the agent yttrium-90 produces encouraging outcomes, especially in patients with portal vein tumor thrombus. This study aims to analyze the outcomes of TARE at our center.
  
  
  METHODS
  From August 2009 to April 2013, 16 patients underwent TARE at our center. Sixteen patients with similar tumor characteristics were selected to undergo TACE alone for comparison. A retrospective analysis of the prospectively collected data of the patients was conducted. Only patients with newly diagnosed primary tumors were included in this study.
  
  
  RESULTS
  The median survival for patients having TARE was 19.9 versus 14.0 months in the TACE group (P=0.615). There was no difference in terms of tumor response according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) (P=0.632). The 1-, 2- and 3-year survival rates in the TARE group were 80.0%, 30.5% and 20.3% respectively. The 1-year survival in the TACE group was 58.3% (P=0.615). For patients who had major vascular invasion (eight in each group), the 1- and 2-year survival rates in the TARE group were 62.5% and 15.6% respectively, while the 1-year survival in the TACE group was 35.0% (P=0.664).
  
  
  CONCLUSIONS
  The two groups showed similar results in terms of tumor response and overall survival benefit. TARE might provide a survival benefit for patients with major vessel invasion.
authors.affiliation: 1 Department of Surgery, 2 Department of Diagnostic Radiology, 3 Department of Clinical Oncology, The University of Hong Kong, Hong Kong, China.
authors.forename: Wong Hoi
authors.initials: WH
authors.lastname: She
authors.affiliation: 1 Department of Surgery, 2 Department of Diagnostic Radiology, 3 Department of Clinical Oncology, The University of Hong Kong, Hong Kong, China.
authors.forename: Tan To
authors.initials: TT
authors.lastname: Cheung
authors.affiliation: 1 Department of Surgery, 2 Department of Diagnostic Radiology, 3 Department of Clinical Oncology, The University of Hong Kong, Hong Kong, China.
authors.forename: Thomas C C
authors.initials: TC
authors.lastname: Yau
authors.affiliation: 1 Department of Surgery, 2 Department of Diagnostic Radiology, 3 Department of Clinical Oncology, The University of Hong Kong, Hong Kong, China.
authors.forename: Albert C Y
authors.initials: AC
authors.lastname: Chan
authors.affiliation: 1 Department of Surgery, 2 Department of Diagnostic Radiology, 3 Department of Clinical Oncology, The University of Hong Kong, Hong Kong, China.
authors.forename: Kenneth S H
authors.initials: KS
authors.lastname: Chok
authors.affiliation: 1 Department of Surgery, 2 Department of Diagnostic Radiology, 3 Department of Clinical Oncology, The University of Hong Kong, Hong Kong, China.
authors.forename: Ferdinand S K
authors.initials: FS
authors.lastname: Chu
authors.affiliation: 1 Department of Surgery, 2 Department of Diagnostic Radiology, 3 Department of Clinical Oncology, The University of Hong Kong, Hong Kong, China.
authors.forename: Rico K Y
authors.initials: RK
authors.lastname: Liu
authors.affiliation: 1 Department of Surgery, 2 Department of Diagnostic Radiology, 3 Department of Clinical Oncology, The University of Hong Kong, Hong Kong, China.
authors.forename: Ronnie T P
authors.initials: RT
authors.lastname: Poon
authors.affiliation: 1 Department of Surgery, 2 Department of Diagnostic Radiology, 3 Department of Clinical Oncology, The University of Hong Kong, Hong Kong, China.
authors.forename: See Ching
authors.initials: SC
authors.lastname: Chan
authors.affiliation: 1 Department of Surgery, 2 Department of Diagnostic Radiology, 3 Department of Clinical Oncology, The University of Hong Kong, Hong Kong, China.
authors.forename: Sheung Tat
authors.initials: ST
authors.lastname: Fan
authors.affiliation: 1 Department of Surgery, 2 Department of Diagnostic Radiology, 3 Department of Clinical Oncology, The University of Hong Kong, Hong Kong, China.
authors.forename: Chung Mau
authors.initials: CM
authors.lastname: Lo
keywords: Hepatocellular carcinoma (HCC); inoperable; transarterial chemoembolization (TACE); transarterial radioembolization (TARE); unresectable; vascular invasion; yttrium-90