PMID- 35346857
OWN - NLM
STAT- MEDLINE
DCOM- 20220706
LR  - 20220807
IS  - 1535-7732 (Electronic)
IS  - 1051-0443 (Linking)
VI  - 33
IP  - 7
DP  - 2022 Jul
TI  - Radiation Segmentectomy for the Treatment of Solitary Hepatocellular Carcinoma: 
      Outcomes Compared with Those of Surgical Resection.
PG  - 775-785.e2
LID - S1051-0443(22)00150-6 [pii]
LID - 10.1016/j.jvir.2022.03.021 [doi]
AB  - PURPOSE: To investigate the outcomes of radiation segmentectomy (RS) versus 
      standard-of-care surgical resection (SR). MATERIALS AND METHODS: A multisite, 
      retrospective analysis of treatment-naive patients who underwent either RS or SR 
      was performed. The inclusion criteria were solitary hepatocellular carcinoma </=8 
      cm in size, Eastern Cooperative Oncology Cohort performance status of 0-1, and 
      absence of macrovascular invasion or extrahepatic disease. Target tumor and 
      overall progression, time to progression (TTP), and overall survival rates were 
      assessed. Outcomes were censored for liver transplantation. RESULTS: A total of 
      123 patients were included (RS, 57; SR, 66). Tumor size, Child-Pugh class, 
      albumin-bilirubin score, platelet count, and fibrosis stage were significantly 
      different between cohorts (P </= .01). Major adverse events (AEs), defined as grade 
      >/=3 per the Clavien-Dindo classification, occurred in 0 patients in the RS cohort 
      vs 13 (20%) patients in the SR cohort (P < .001). Target tumor progression 
      occurred in 3 (5%) patients who underwent RS and 5 (8%) patients who underwent 
      SR. Overall progression occurred in 19 (33%) patients who underwent RS and 21 
      (32%) patients who underwent SR. The median overall TTP was 21.9 and 29.4 months 
      after RS and SR, respectively (95% confidence interval [CI], 15.5-28.2 and 
      18.5-40.3, respectively; P = .03). Overall TTP subgroup analyses showed no 
      difference between treatment cohorts with fibrosis stages 3-4 (P = .26) and a 
      platelet count of <150 x 10(9)/L (P = .29). The overall progression hazard ratio 
      for RS versus SR was not significant per the multivariate Cox regression analysis 
      (1.16; 95% CI, 0.51-2.63; P = .71). The median overall survival was not reached 
      for either of the cohorts. Propensity scores were calculated but were too 
      dissimilar for analysis. CONCLUSIONS: RS and SR were performed in different 
      patient populations, which limits comparison. RS approached SR outcomes, with a 
      lower incidence of major AEs, in patients who were not eligible for hepatectomy.
CI  - Copyright (c) 2022 SIR. Published by Elsevier Inc. All rights reserved.
FAU - De la Garza-Ramos, Cynthia
AU  - De la Garza-Ramos C
AD  - Division of Interventional Radiology, Mayo Clinic, Jacksonville, Florida.
FAU - Montazeri, S Ali
AU  - Montazeri SA
AD  - Division of Interventional Radiology, Mayo Clinic, Jacksonville, Florida.
FAU - Croome, Kristopher P
AU  - Croome KP
AD  - Department of Transplant, Mayo Clinic, Jacksonville, Florida.
FAU - LeGout, Jordan D
AU  - LeGout JD
AD  - Department of Radiology, Mayo Clinic, Jacksonville, Florida.
FAU - Sella, David M
AU  - Sella DM
AD  - Department of Radiology, Mayo Clinic, Jacksonville, Florida.
FAU - Cleary, Sean
AU  - Cleary S
AD  - Division of Hepatobiliary and Pancreatic Surgery, Mayo Clinic, Rochester, 
      Minnesota.
FAU - Burns, Justin
AU  - Burns J
AD  - Department of Transplant, Mayo Clinic, Jacksonville, Florida.
FAU - Mathur, Amit K
AU  - Mathur AK
AD  - Division of Transplant Surgery, Mayo Clinic, Phoenix, Arizona.
FAU - Overfield, Cameron J
AU  - Overfield CJ
AD  - Division of Interventional Radiology, Mayo Clinic, Jacksonville, Florida.
FAU - Frey, Gregory T
AU  - Frey GT
AD  - Division of Interventional Radiology, Mayo Clinic, Jacksonville, Florida.
FAU - Lewis, Andrew R
AU  - Lewis AR
AD  - Division of Interventional Radiology, Mayo Clinic, Jacksonville, Florida.
FAU - Paz-Fumagalli, Ricardo
AU  - Paz-Fumagalli R
AD  - Division of Interventional Radiology, Mayo Clinic, Jacksonville, Florida.
FAU - Ritchie, Charles A
AU  - Ritchie CA
AD  - Division of Interventional Radiology, Mayo Clinic, Jacksonville, Florida.
FAU - McKinney, J Mark
AU  - McKinney JM
AD  - Division of Interventional Radiology, Mayo Clinic, Jacksonville, Florida.
FAU - Mody, Kabir
AU  - Mody K
AD  - Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, Florida.
FAU - Patel, Tushar
AU  - Patel T
AD  - Department of Transplant, Mayo Clinic, Jacksonville, Florida.
FAU - Devcic, Zlatko
AU  - Devcic Z
AD  - Division of Interventional Radiology, Mayo Clinic, Jacksonville, Florida.
FAU - Toskich, Beau B
AU  - Toskich BB
AD  - Division of Interventional Radiology, Mayo Clinic, Jacksonville, Florida. 
      Electronic address: Toskich.Beau@mayo.edu.
LA  - eng
PT  - Journal Article
DEP - 20220326
PL  - United States
TA  - J Vasc Interv Radiol
JT  - Journal of vascular and interventional radiology : JVIR
JID - 9203369
SB  - IM
MH  - *Carcinoma, Hepatocellular/diagnostic imaging/radiotherapy/surgery
MH  - Fibrosis
MH  - Hepatectomy/adverse effects
MH  - Humans
MH  - *Liver Neoplasms/diagnostic imaging/radiotherapy/surgery
MH  - Pneumonectomy
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 2022/03/30 06:00
MHDA- 2022/07/07 06:00
CRDT- 2022/03/29 05:43
PHST- 2021/09/20 00:00 [received]
PHST- 2022/01/26 00:00 [revised]
PHST- 2022/03/13 00:00 [accepted]
PHST- 2022/03/30 06:00 [pubmed]
PHST- 2022/07/07 06:00 [medline]
PHST- 2022/03/29 05:43 [entrez]
AID - S1051-0443(22)00150-6 [pii]
AID - 10.1016/j.jvir.2022.03.021 [doi]
PST - ppublish
SO  - J Vasc Interv Radiol. 2022 Jul;33(7):775-785.e2. doi: 10.1016/j.jvir.2022.03.021. 
      Epub 2022 Mar 26.