A RECENT study has found that Yttrium-90 transarterial radioembolisation (Y-90 TARE) significantly improves survival rates compared to transarterial hepatic embolisation (TAE) in patients with large hepatocellular carcinoma (HCC)HCC is often diagnosed at an advanced stage, with more than half of patients presenting with tumours larger than 7 cm. These tumours are difficult to treat surgically due to the risk of severe liver damage. This study aimed to assess and compare the effectiveness of Y-90 TARE and TAE in patients with such tumours, demonstrating that Y-90 TARE not only enhances survival outcomes, but also offers better tumour control.
Researchers retrospectively reviewed 66 patients who underwent either Y-90 TARE (n=22) or TAE (n=44) between January 2013 and December 2023. The average tumour size was 10.4 cm for the TAE group and 10.7 cm for the Y-90 TARE group. Importantly, patients in the TARE group experienced significantly longer locoregional progression-free survival (21.6 months vs 4.6 months; p<0.001) and overall survival (23.6 months vs 15.2 months; p=0.252). Additionally, fewer hospital stays were required for TARE, as all TAE patients were admitted for at least one day, with nearly 50% staying longer than two days, while the majority of TARE patients did not require extended stays. Both treatments also showed similar adverse event profiles, with 50% of TAE patients experiencing mild side effects compared to 27% of Y-90 TARE patients.
While these findings highlight the potential advantages of Y-90 TARE over TAE in treating large HCC tumours, the authors note limitations, including the fact that the retrospective design limits the ability to draw definitive conclusions. The researchers emphasised the need for prospective studies to confirm these results. In clinical practice, these findings suggest that Y-90 TARE may be a more effective treatment option for patients with large HCC tumours, particularly in terms of survival and disease control. Given its reduced hospitalisation requirements and improved outcomes, TARE could become the preferred treatment in many cases, although further research is required to fully validate these findings.
Reference
Son, SY et al. Outcomes of Transarterial Hepatic Embolization versus Yttrium-90 Radioembolization for Treatment of Patients with Hepatocellular Carcinoma > 7 cm. J Vasc Interv Radiol. 2025; DOI: 10.1016/j.jvir.2025.03.006.
