title: [Selective internal radioembolization in nonresectable hepatocellular carcinoma].
abstract: BACKGROUND
  The role of selective internal radioembolization (SIRT) in the treatment of hepatocellular carcinoma (HCC) is currently unclear.
  
  
  METHODS
  We investigated 52 patients with nonresectable HCC in cirrhosis who underwent SIRT at the Department of General, Visceral and Vascular Surgery in co-operation with the Department of Nuclear Medicine and the Institute of Diagnostic and Interventional Radiology between April 2011 and October 2015.
  
  
  RESULTS
  In five patients, SIRT was employed for bridging to liver transplantation. In patients who had undergone pre-treatment with SIRT, histological examination of the explanted livers showed extensive tumor necrosis in the targeted areas with only minor remnant vital tissue at the margins. Four of the patients who underwent SIRT as local bridging treatment are tumor-free after transplantation. In the 47 palliatively treated patients, a total of 76 radioembolizations were performed. The observed 1‑ and 2‑year survival rates in these patients were 58 and 29 %, respectively, after the first SIRT. In the multivariate analysis of the observed survival, AFP before the first SIRT >30ng/ml, time interval of <12 months between the initial diagnosis and the first SIRT, largest tumor diameter >5 cm and portal vein thrombosis were independent negative prognostic factors. In the multi-variate analysis, the time to progression was independently influenced only by the AFP level before the first SIRT. In addition to standard treatment with transarterial chemoembolization (TACE), SIRT is feasible in nonresectable HCC, in particular with portal vein thrombosis, with identical results, less interventions and few side effects.
authors.affiliation: Klinik für Allgemein-,Visceral-und Gefäßchirurgie, Universitätsklinikum Jena, Erlanger Allee 101, 07740, Jena, Deutschland. astrid.bauschke@med.uni-jena.de.
authors.forename: A
authors.initials: A
authors.lastname: Bauschke
authors.affiliation: Klinik für Allgemein-,Visceral-und Gefäßchirurgie, Universitätsklinikum Jena, Erlanger Allee 101, 07740, Jena, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Altendorf-Hofmann
authors.affiliation: Klinik für Nuklearmedizin, Universitätsklinikum Jena, Jena, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Freesmeyer
authors.affiliation: Klinik für Nuklearmedizin, Universitätsklinikum Jena, Jena, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Winkens
authors.affiliation: Klinik für Allgemein-,Visceral-und Gefäßchirurgie, Universitätsklinikum Jena, Erlanger Allee 101, 07740, Jena, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Malessa
authors.affiliation: Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Jena, Jena, Deutschland.
authors.forename: J-H
authors.initials: JH
authors.lastname: Schierz
authors.affiliation: Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Jena, Jena, Deutschland.
authors.forename: U
authors.initials: U
authors.lastname: Teichgraeber
authors.affiliation: Klinik für Allgemein-,Visceral-und Gefäßchirurgie, Universitätsklinikum Jena, Erlanger Allee 101, 07740, Jena, Deutschland.
authors.forename: U
authors.initials: U
authors.lastname: Settmacher
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D033183:Interdisciplinary Communication; D000070516:Intersectoral Collaboration; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016031:Liver Transplantation; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D011446:Prospective Studies; D016019:Survival Analysis; D015021:Yttrium Radioisotopes / Q000008:administration & dosage
chemical_list: D015021:Yttrium Radioisotopes
keywords: Nonresectable HCC; Prognostic factors; Radioembolization; SIRT; Survival