Survival comparison of hepatocellular carcinoma patients treated with radioembolization versus nonoperative/interventional treatment
Abstract
Aim: To compare the overall survival (OS) and liver cancer-specific survival of advanced-stage hepatocellular carcinoma (HCC) patients who received transarterial radioembolization (TARE) with those who received nonoperative/interventional treatment (NOT). Materials & methods: A total of 12,520 HCC patients from the Surveillance, Epidemiology and End Results database were categorized by treatment with either radioembolization or NOT. Kaplan–Meier and multivariate Cox regression were conducted. Results: The TARE group had both a significantly longer median overall survival than the NOT group (TARE = 9 months; NOT = 2 months; p < 0.0001) and a significantly higher probability of liver cancer-specific survival (hazard ratio = 0.474). Conclusion: TARE appears to provide a significant survival advantage over the NOT population in advanced HCC patients.
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References
Papers of special note have been highlighted as: • of interest; •• of considerable interest
1.
Luo W, Zhang Y, He G et al. Effects of radiofrequency ablation versus other ablating techniques on hepatocellular carcinomas: a systematic review and meta-analysis. World J. Surg. Oncol. 15(1), 126 (2017).
•• The Phase III prospective comparisons of transarterial radioembolization (TARE) and sorafenib provide a look into the efficacies of various tumoricidal treatments for advanced hepatocellular carcinoma patients.
2.
Vigano L, Conci S, Cescon M et al. Liver resection for hepatocellular carcinoma in patients with metabolic syndrome: a multicenter matched analysis with HCV-related HCC. J. Hepatol. 63(1), 93–101 (2015).
3.
Sharma P, Balan V, Hernandez JL et al. Liver transplantation for hepatocellular carcinoma: the MELD impact. Liver Transpl. 10(1), 36–41 (2004).
4.
Mazzaferro V, Regalia E, Doci R et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N. Engl. J. Med. 334(11), 693–699 (1996).
5.
Belghiti J, Kianmanesh R. Surgical treatment of hepatocellular carcinoma. HPB (Oxford) 7(1), 42–49 (2005).
6.
Regimbeau JM, Abdalla EK, Vauthey JN et al. Risk factors for early death due to recurrence after liver resection for hepatocellular carcinoma: results of a multicenter study. J. Surg. Oncol. 85(1), 36–41 (2004).
7.
Eltawil KM, Berry R, Abdolell M, Molinari M. Quality of life and survival analysis of patients undergoing transarterial chemoembolization for primary hepatic malignancies: a prospective cohort study. HPB (Oxford) 14(5), 341–350 (2012).
8.
Llovet JM, Real MI, Montana X et al. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet 359(9319), 1734–1739 (2002).
9.
Llovet JM, Ricci S, Mazzaferro V et al. Sorafenib in advanced hepatocellular carcinoma. N. Engl. J. Med. 359(4), 378–390 (2008).
10.
Abdel-Rahman O, Lamarca A, Valle JW, Hubner RA. Somatostatin receptor expression in hepatocellular carcinoma: prognostic and therapeutic considerations. Endocr. Relat. Cancer 21(6), R485–R493 (2014).
11.
Biederman DM, Titano JJ, Tabori NE et al. Outcomes of radioembolization in the treatment of hepatocellular carcinoma with portal vein invasion: resin versus glass microspheres. J. Vasc. Interv. Radiol. 27(6), 812.e2–821.e2 (2016).
12.
Adhoute X, Penaranda G, Raoul JL et al. Barcelona clinic liver cancer nomogram and others staging/scoring systems in a French hepatocellular carcinoma cohort. World J. Gastroenterol. 23(14), 2545–2555 (2017).
13.
Camma C, Schepis F, Orlando A et al. Transarterial chemoembolization for unresectable hepatocellular carcinoma: meta-analysis of randomized controlled trials. Radiology 224(1), 47–54 (2002).
14.
Sacco R, Conte C, Tumino E et al. Transarterial radioembolization for hepatocellular carcinoma: a review. J. Hepatocell. Carcinoma 3, 25–29 (2016).
15.
Mazzaferro V, Sposito C, Bhoori S et al. Yttrium-90 radioembolization for intermediate-advanced hepatocellular carcinoma: a Phase II study. Hepatology 57(5), 1826–1837 (2013).
16.
Rognoni C, Ciani O, Sommariva S et al. Trans-arterial radioembolization in intermediate-advanced hepatocellular carcinoma: systematic review and meta-analyses. Oncotarget 7(44), 72343–72355 (2016).
• Provides the curious reader with a compilation analysis of survivals from a variety of radioembolization efficacy studies and may help to point to more specific case-based scenarios.
17.
Liver EaFTSOT. SIRT is better tolerated than sorafenib, but doesn't increase overall survival in HCC. Eurekalert! (2017). www.eurekalert.org/pub_releases/2017-04/eaft-sib041217.php
18.
Chow PHW, Gandhi M. Phase III multi-centre open-label randomized controlled trial of selective internal radiation therapy (SIRT) versus sorafenib in locally advanced hepatocellular carcinoma: The SIRveNIB study. J. Clin. Oncol. 35(Suppl. 15), 4002 (2017).
•• The Phase III prospective comparisons of TARE and sorafenib provide a look into the efficacies of various tumoricidal treatments for advanced hepatocellular carcinoma patients.
19.
Gramenzi A, Golfieri R, Mosconi C et al. Yttrium-90 radioembolization vs sorafenib for intermediate-locally advanced hepatocellular carcinoma: a cohort study with propensity score analysis. Liver Int. 35(3), 1036–1047 (2015).
• Introduces a propensity matched investigation of TARE versus sorafenib for those who are curious about a greater separation between nonoperative/interventional treatment and sorafenib receiving patients.
20.
National Cancer Institute. Overview of the SEER program (2017). https://seer.cancer.gov/about/overview.html
21.
Adamo M, Dickie L, Ruhl J. SEER Program Coding and Staging Manual. National Cancer Institute, MD, USA (2016). www.eurekalert.org/pub_releases/2017-04/eaft-sib041217.php
•• Investigation into the Surveillance, Epidemiology and End Results manual for coding will help the curious reader further understand the methodology and aim of this study.
22.
Austin PC. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behav. Res. 46(3), 399–424 (2011).
•• Propensity matching as an effective tool for mimicking randomized control trials in retrospective analysis studies.
23.
Coca-Perraillon M. Local and global optimal propensity score matching. SAS Global forum paper, 185–2007 (2007). www2.sas.com/proceedings/forum2007/185-2007.pdf
24.
Abdelfattah MR, Al-Sebayel M, Broering D, Alsuhaibani H. Radioembolization using yttrium-90 microspheres as bridging and downstaging treatment for unresectable hepatocellular carcinoma before liver transplantation: initial single-center experience. Transplant Proc. 47(2), 408–411 (2015).
25.
Kulik LM, Carr BI, Mulcahy MF et al. Safety and efficacy of 90Y radiotherapy for hepatocellular carcinoma with and without portal vein thrombosis. Hepatology 47(1), 71–81 (2008).
26.
Sangro B, Carpanese L, Cianni R et al. Survival after yttrium-90 resin microsphere radioembolization of hepatocellular carcinoma across Barcelona clinic liver cancer stages: a European evaluation. Hepatology 54(3), 868–878 (2011).
27.
Oladeru OT, Miccio JA, Yang J, Xue Y, Ryu S, Stessin AM. Conformal external beam radiation or selective internal radiation therapy – a comparison of treatment outcomes for hepatocellular carcinoma. J. Gastrointest. Oncol. 7(3), 433–440 (2016).
28.
Gray SH, White JA, Li P et al. A SEER database analysis of the survival advantage of transarterial chemoembolization for hepatocellular carcinoma: an underutilized therapy. J. Vasc. Interv. Radiol. 28(2), 231.e2–237.e2 (2017).
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© 2018 Future Medicine Ltd.
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Received: 14 August 2017
Accepted: 27 October 2017
Published online: 19 March 2018
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Survival comparison of hepatocellular carcinoma patients treated with radioembolization versus nonoperative/interventional treatment. (2018) Journal of Comparative Effectiveness Research. DOI: 10.2217/cer-2017-0064
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