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Improved Survival after Transarterial Radioembolisation for Hepatocellular Carcinoma Gives the Procedure Added Value
Background: Transarterial Radioembolisation (TARE) requires multidisciplinary experience and skill to be effective. The aim of this study was to identify determinants of survival in patients with hepatocellular carcinoma (HCC), focusing on learning curves, technical advancements, patient selection a...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9781303/ https://www.ncbi.nlm.nih.gov/pubmed/36556085 http://dx.doi.org/10.3390/jcm11247469 |
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author | Mosconi, Cristina Cappelli, Alberta Pettinato, Cinzia Cocozza, Maria Adriana Vara, Giulio Terzi, Eleonora Morelli, Maria Cristina Lodi Rizzini, Elisa Renzulli, Matteo Modestino, Francesco Serenari, Matteo Bonfiglioli, Rachele Calderoni, Letizia Tabacchi, Elena Cescon, Matteo Morganti, Alessio Giuseppe Trevisani, Franco Piscaglia, Fabio Fanti, Stefano Strigari, Lidia Cucchetti, Alessandro Golfieri, Rita |
author_facet | Mosconi, Cristina Cappelli, Alberta Pettinato, Cinzia Cocozza, Maria Adriana Vara, Giulio Terzi, Eleonora Morelli, Maria Cristina Lodi Rizzini, Elisa Renzulli, Matteo Modestino, Francesco Serenari, Matteo Bonfiglioli, Rachele Calderoni, Letizia Tabacchi, Elena Cescon, Matteo Morganti, Alessio Giuseppe Trevisani, Franco Piscaglia, Fabio Fanti, Stefano Strigari, Lidia Cucchetti, Alessandro Golfieri, Rita |
author_sort | Mosconi, Cristina |
collection | PubMed |
description | Background: Transarterial Radioembolisation (TARE) requires multidisciplinary experience and skill to be effective. The aim of this study was to identify determinants of survival in patients with hepatocellular carcinoma (HCC), focusing on learning curves, technical advancements, patient selection and subsequent therapies. Methods: From 2005 to 2020, 253 patients were treated. TARE results achieved in an initial period (2005–2011) were compared to those obtained in a more recent period (2012–2020). To isolate the effect of the treatment period, differences between the two periods were balanced using “entropy balance”. Results: Of the 253 patients, 68 were treated before 2012 and 185 after 2012. In the second period, patients had an Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) score of 1 (p = 0.025) less frequently, less liver involvement (p = 0.006) and a lesser degree of vascular invasion (p = 0.019). The median overall survival (OS) of patients treated before 2012 was 11.2 months and that of patients treated beginning in 2012 was 25.7 months. After reweighting to isolate the effect of the treatment period, the median OS of patients before 2012 increased to 16 months. Conclusions: Better patient selection, refinement of technique and adoption of personalised dosimetry improved survival after TARE. Conversely, sorafenib after TARE did not impact life expectancy. |
format | Online Article Text |
id | pubmed-9781303 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-97813032022-12-24 Improved Survival after Transarterial Radioembolisation for Hepatocellular Carcinoma Gives the Procedure Added Value Mosconi, Cristina Cappelli, Alberta Pettinato, Cinzia Cocozza, Maria Adriana Vara, Giulio Terzi, Eleonora Morelli, Maria Cristina Lodi Rizzini, Elisa Renzulli, Matteo Modestino, Francesco Serenari, Matteo Bonfiglioli, Rachele Calderoni, Letizia Tabacchi, Elena Cescon, Matteo Morganti, Alessio Giuseppe Trevisani, Franco Piscaglia, Fabio Fanti, Stefano Strigari, Lidia Cucchetti, Alessandro Golfieri, Rita J Clin Med Article Background: Transarterial Radioembolisation (TARE) requires multidisciplinary experience and skill to be effective. The aim of this study was to identify determinants of survival in patients with hepatocellular carcinoma (HCC), focusing on learning curves, technical advancements, patient selection and subsequent therapies. Methods: From 2005 to 2020, 253 patients were treated. TARE results achieved in an initial period (2005–2011) were compared to those obtained in a more recent period (2012–2020). To isolate the effect of the treatment period, differences between the two periods were balanced using “entropy balance”. Results: Of the 253 patients, 68 were treated before 2012 and 185 after 2012. In the second period, patients had an Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) score of 1 (p = 0.025) less frequently, less liver involvement (p = 0.006) and a lesser degree of vascular invasion (p = 0.019). The median overall survival (OS) of patients treated before 2012 was 11.2 months and that of patients treated beginning in 2012 was 25.7 months. After reweighting to isolate the effect of the treatment period, the median OS of patients before 2012 increased to 16 months. Conclusions: Better patient selection, refinement of technique and adoption of personalised dosimetry improved survival after TARE. Conversely, sorafenib after TARE did not impact life expectancy. MDPI 2022-12-16 /pmc/articles/PMC9781303/ /pubmed/36556085 http://dx.doi.org/10.3390/jcm11247469 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Mosconi, Cristina Cappelli, Alberta Pettinato, Cinzia Cocozza, Maria Adriana Vara, Giulio Terzi, Eleonora Morelli, Maria Cristina Lodi Rizzini, Elisa Renzulli, Matteo Modestino, Francesco Serenari, Matteo Bonfiglioli, Rachele Calderoni, Letizia Tabacchi, Elena Cescon, Matteo Morganti, Alessio Giuseppe Trevisani, Franco Piscaglia, Fabio Fanti, Stefano Strigari, Lidia Cucchetti, Alessandro Golfieri, Rita Improved Survival after Transarterial Radioembolisation for Hepatocellular Carcinoma Gives the Procedure Added Value |
title | Improved Survival after Transarterial Radioembolisation for Hepatocellular Carcinoma Gives the Procedure Added Value |
title_full | Improved Survival after Transarterial Radioembolisation for Hepatocellular Carcinoma Gives the Procedure Added Value |
title_fullStr | Improved Survival after Transarterial Radioembolisation for Hepatocellular Carcinoma Gives the Procedure Added Value |
title_full_unstemmed | Improved Survival after Transarterial Radioembolisation for Hepatocellular Carcinoma Gives the Procedure Added Value |
title_short | Improved Survival after Transarterial Radioembolisation for Hepatocellular Carcinoma Gives the Procedure Added Value |
title_sort | improved survival after transarterial radioembolisation for hepatocellular carcinoma gives the procedure added value |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9781303/ https://www.ncbi.nlm.nih.gov/pubmed/36556085 http://dx.doi.org/10.3390/jcm11247469 |
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