PMID- 30268638 OWN - NLM STAT- MEDLINE DCOM- 20190409 LR - 20190409 IS - 1535-7732 (Electronic) IS - 1051-0443 (Linking) VI - 29 IP - 11 DP - 2018 Nov TI - Outcomes of Surgical Resection after Radioembolization for Hepatocellular Carcinoma. PG - 1502-1510.e1 LID - S1051-0443(18)31333-2 [pii] LID - 10.1016/j.jvir.2018.06.027 [doi] AB - PURPOSE: To longitudinally study clinical and radiologic outcomes of patients with hepatocellular carcinoma (HCC) who underwent yttrium-90 transarterial radioembolization (TARE) as a bridge to surgical resection. MATERIALS AND METHODS: TARE was performed in 31 patients with HCC before resection. Of patients, 25 underwent major hepatic resection (16 received right hepatectomy and 9 received trisegmentectomy), and 6 underwent partial hepatectomy. Clinical outcomes after TARE and after resection were recorded. Future liver remnant (FLR) was calculated before and after TARE, and actual liver remnant volume was calculated after resection. Radiologic response after TARE and pathologic necrosis were assessed. Overall and recurrence-free survivals after resection were estimated. RESULTS: Median time between TARE and resection was 2.9 months (interquartile range [IQR]: 2-5 months). Median FLR hypertrophy after TARE (and before resection) was 23.3% (IQR:10%-48%) for patients who had radiation lobectomy and 9% (IQR: 6%-25%) for patients who had radiation segmentectomy (P = .037). Median augmented hypertrophy of the liver remnant 3 months after resection was 72% (IQR:45%-88%) in patients who had radiation lobectomy and 94% (IQR: 72%-146%) in patients who had radiation segmentectomy. Complete, 50%-99%, and < 50% pathologic tumor necrosis was identified in 14 (45%), 10 (32%), and 7 (23%) tumors. Disease control was achieved in all 31 patients. Survival rates at 1 and 3 years were 96% and 86%, respectively. Median recurrence-free survival was 34.2 months (95% confidence interval,18.7-34.2). CONCLUSIONS: TARE can serve as a safe bridge to resection providing FLR hypertrophy and disease control. CI - Copyright (c) 2018 SIR. Published by Elsevier Inc. All rights reserved. FAU - Gabr, Ahmed AU - Gabr A AD - Section of Interventional Radiology, Department of Radiology, Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL 60611. FAU - Abouchaleh, Nadine AU - Abouchaleh N AD - Section of Interventional Radiology, Department of Radiology, Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL 60611. FAU - Ali, Rehan AU - Ali R AD - Section of Interventional Radiology, Department of Radiology, Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL 60611. FAU - Baker, Talia AU - Baker T AD - Comprehensive Transplant Center, Division of Transplantation, Department of Surgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Suite 800, Chicago, IL 60611. FAU - Caicedo, Juan AU - Caicedo J AD - Comprehensive Transplant Center, Division of Transplantation, Department of Surgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Suite 800, Chicago, IL 60611. FAU - Katariya, Nitin AU - Katariya N AD - Comprehensive Transplant Center, Division of Transplantation, Department of Surgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Suite 800, Chicago, IL 60611. FAU - Abecassis, Michael AU - Abecassis M AD - Comprehensive Transplant Center, Division of Transplantation, Department of Surgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Suite 800, Chicago, IL 60611. FAU - Riaz, Ahsun AU - Riaz A AD - Section of Interventional Radiology, Department of Radiology, Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL 60611. FAU - Lewandowski, Robert J AU - Lewandowski RJ AD - Section of Interventional Radiology, Department of Radiology, Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL 60611; Department of Medicine, Division of Hematology and Oncology, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL 60611. FAU - Salem, Riad AU - Salem R AD - Section of Interventional Radiology, Department of Radiology, Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL 60611; Department of Medicine, Division of Hematology and Oncology, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL 60611; Comprehensive Transplant Center, Division of Transplantation, Department of Surgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Suite 800, Chicago, IL 60611. Electronic address: r-salem@northwestern.edu. LA - eng PT - Journal Article DEP - 20180927 PL - United States TA - J Vasc Interv Radiol JT - Journal of vascular and interventional radiology : JVIR JID - 9203369 RN - 0 (Radiopharmaceuticals) RN - 0 (Yttrium Radioisotopes) RN - 1K8M7UR6O1 (Yttrium-90) SB - IM MH - Adult MH - Aged MH - Biopsy MH - Carcinoma, Hepatocellular/diagnostic imaging/*radiotherapy/secondary/*surgery MH - Embolization, Therapeutic/adverse effects/*methods MH - Female MH - *Hepatectomy/adverse effects MH - Humans MH - Liver Neoplasms/diagnostic imaging/pathology/*radiotherapy/*surgery MH - Liver Regeneration MH - Magnetic Resonance Imaging MH - Male MH - Middle Aged MH - Necrosis MH - Neoplasm Recurrence, Local MH - Progression-Free Survival MH - Radiopharmaceuticals/*administration & dosage/adverse effects MH - Retrospective Studies MH - Risk Factors MH - Time Factors MH - Treatment Outcome MH - Yttrium Radioisotopes/*administration & dosage/adverse effects EDAT- 2018/10/01 06:00 MHDA- 2019/04/10 06:00 CRDT- 2018/10/01 06:00 PHST- 2017/09/01 00:00 [received] PHST- 2018/06/01 00:00 [revised] PHST- 2018/06/04 00:00 [accepted] PHST- 2018/10/01 06:00 [pubmed] PHST- 2019/04/10 06:00 [medline] PHST- 2018/10/01 06:00 [entrez] AID - S1051-0443(18)31333-2 [pii] AID - 10.1016/j.jvir.2018.06.027 [doi] PST - ppublish SO - J Vasc Interv Radiol. 2018 Nov;29(11):1502-1510.e1. doi: 10.1016/j.jvir.2018.06.027. Epub 2018 Sep 27.