Transarterial Radioembolization Versus Chemoembolization for Unresectable Large Single Hepatocellular Carcinoma.
- 1Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
- 2Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of Korea.
- 3Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea. [email protected].
Abstract
Objective
To compare oncologic outcomes and safety between transarterial radioembolization (TARE) and transarterial chemoembolization (TACE) in patients with unresectable large solitary hepatocellular carcinomas (HCCs; ≥6 cm).Materials and methods
This single-center retrospective study included patients with a solitary HCC ≥6 cm who underwent initial treatment with TARE or TACE between January 2010 and December 2023. Patients who were initially scheduled to undergo TARE but were subsequently treated with TACE because of a high lung shunt fraction (LSF) were included in the TACE group. The primary outcome was overall survival (OS), and secondary outcomes included progression-free survival (PFS), local PFS, tumor response, and safety. Inverse probability of treatment weighting (IPTW) was used to adjust for baseline differences in the survival analyses.Results
In total, 306 patients were included in this study (TACE, n = 187; TARE, n = 119). Before IPTW adjustment, the TARE group demonstrated significantly longer OS than the TACE group (median, 79.6 vs. 46.5 months; P = 0.004). Patients who were ineligible for TARE because of extensive lung shunting demonstrated particularly poor survival (median OS, 20.3 months). After IPTW adjustment, TARE remained associated with longer OS (median, 79.6 vs. 53.4 months; P = 0.033) and local PFS (median, 25.1 vs. 9.5 months; P = 0.001). Median PFS remained numerically longer with TARE (9.8 vs. 7.8 months), but the difference did not reach statistical significance (P = 0.066). In comparison with TACE, TARE was associated with less frequent serious adverse events (10.1% vs. 26.7%; P < 0.01) and a markedly lower rate of prolonged hospitalization (>7 days) (0.8% vs. 22.5%; P < 0.01).Conclusion
In patients with unresectable large solitary HCCs, TARE was associated with longer OS, improved local tumor control, and fewer serious adverse events than TACE. However, the survival advantage should be interpreted with caution, because biological selection related to LSF eligibility may have contributed to the observed difference.
Related
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BibTeX
@article{lee2026transarterial,
title = {{Transarterial Radioembolization Versus Chemoembolization for Unresectable Large Single Hepatocellular Carcinoma.}},
author = {Myungsu Lee and Minuk Kim and Jayoun Kim and Do Hoon Kim and Jin Wook Chung and Hyo-Cheol Kim},
journal = {Korean journal of radiology},
year = {2026},
month = oct,
doi = {10.3348/kjr.2026.0458},
url = {https://europepmc.org/article/MED/42849888},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Transarterial Radioembolization Versus Chemoembolization for Unresectable Large Single Hepatocellular Carcinoma.
AU - Myungsu Lee
AU - Minuk Kim
AU - Jayoun Kim
AU - Do Hoon Kim
AU - Jin Wook Chung
AU - Hyo-Cheol Kim
PY - 2026
DA - 2026/10/01
JO - Korean journal of radiology
DO - 10.3348/kjr.2026.0458
UR - https://europepmc.org/article/MED/42849888
AB - Objective To compare oncologic outcomes and safety between transarterial radioembolization (TARE) and transarterial chemoembolization (TACE) in patients with unresectable large solitary hepatocellular carcinomas (HCCs; ≥6 cm).Materials and methods This single-center retrospective study included patients with a solitary HCC ≥6 cm who underwent initial treatment with TARE or TACE between January 2010 and December 2023. Patients who were initially scheduled to undergo TARE but were subsequently treated with TACE because of a high lung shunt fraction (LSF) were included in the TACE group. The primary outcome was overall survival (OS), and secondary outcomes included progression-free survival (PFS), local PFS, tumor response, and safety. Inverse probability of treatment weighting (IPTW) was used to adjust for baseline differences in the survival analyses.Results In total, 306 patients were included in this study (TACE, n = 187; TARE, n = 119). Before IPTW adjustment, the TARE group demonstrated significantly longer OS than the TACE group (median, 79.6 vs. 46.5 months; P = 0.004). Patients who were ineligible for TARE because of extensive lung shunting demonstrated particularly poor survival (median OS, 20.3 months). After IPTW adjustment, TARE remained associated with longer OS (median, 79.6 vs. 53.4 months; P = 0.033) and local PFS (median, 25.1 vs. 9.5 months; P = 0.001). Median PFS remained numerically longer with TARE (9.8 vs. 7.8 months), but the difference did not reach statistical significance (P = 0.066). In comparison with TACE, TARE was associated with less frequent serious adverse events (10.1% vs. 26.7%; P < 0.01) and a markedly lower rate of prolonged hospitalization (>7 days) (0.8% vs. 22.5%; P < 0.01).Conclusion In patients with unresectable large solitary HCCs, TARE was associated with longer OS, improved local tumor control, and fewer serious adverse events than TACE. However, the survival advantage should be interpreted with caution, because biological selection related to LSF eligibility may have contributed to the observed difference.
SN - 1229-6929
SN - 2005-8330
ER -