Trans-arterial radioembolization (TARE) has shown promising results in treating
hepatocellular carcinoma (HCC). We identified independent predictors of radiological complete response (CR) in patients with intrahepatic HCC who were treated with TARE.
METHODS: Patients with intrahepatic HCC treated with TARE between 2011 and 2017 were recruited. CR was defined according to the modified Response Evaluation Criteria in Solid Tumors. Cox regression analysis was used to determine independent predictors of CR.
RESULTS: The median age of study participants (83 men and 19 women) was 64.3 years. The mean survival after TARE was 55.5 months, and 21 (20.6%) patients died during the study period. Patients who achieved CR (14 patients, 13.7%) had significantly higher
serum albumin level (median 4.1 vs. 3.9 g/dL), lower total
bilirubin level (median 0.6 vs. 0.7 mg/dL), lower
aspartate aminotransferase level (median 30.0 vs. 43.0 IU/L), lower
alkaline phosphatase level (median 79.0 vs. 103.0 IU/L), lower
alpha-fetoprotein level (median 12.7 vs. 39.9 ng/mL), lower
des-gamma-carboxyprothrombin level (median 575.5 vs. 2772.0 mAU/mL), lower model for
end-stage liver disease (MELD) score (median 6.0 vs. 7.0), and smaller maximal
tumor diameter (median 6.3 vs. 9.0 cm) compared to those who did not achieve CR (all p < 0.005). Multivariate Cox regression analysis showed that lower MELD score (hazard ratio (HR) = 0.436, p = 0.015) and maximal
tumor size < 9 cm (HR = 11.180, p = 0.020) were independent predictors of an increased probability of radiological CR after TARE.
CONCLUSIONS: Low MELD score and small maximal
tumor size were independently associated with an increased probability of CR after TARE in patients with intrahepatic HCC.