Transarterial Radioembolization (TARE) in Patients with Hepatocellular Carcinoma: A Comparison of Palliative with Bridging-to-Transplant Concepts

Jacqueline Schönherr; Philipp Seifert; Falk Gühne; Thomas Winkens; Falk Rauchfuß; Utz Settmacher; Martin Freesmeyer; Robert Drescher

doi:10.3390/cancers16010235

Transarterial Radioembolization (TARE) in Patients with Hepatocellular Carcinoma: A Comparison of Palliative with Bridging-to-Transplant Concepts

Cancers (Basel). 2024 Jan 4;16(1):235. doi: 10.3390/cancers16010235.

Authors

Jacqueline Schönherr¹, Philipp Seifert¹, Falk Gühne¹, Thomas Winkens¹, Falk Rauchfuß², Utz Settmacher², Martin Freesmeyer¹, Robert Drescher¹

Affiliations

¹ Clinic of Nuclear Medicine, Jena University Hospital, 07747 Jena, Germany.
² Center of Transplant Surgery, Department of General, Visceral and Vascular Surgery, Jena University Hospital, 07747 Jena, Germany.

Abstract

We investigated transarterial radioembolization (TARE) as a palliative measure and bridging-to-transplant therapy in hepatocellular carcinoma (HCC) patients. A total of 167 patients (50 bridging, 117 palliative) with 245 TARE procedures were assessed. Fourteen patients underwent subsequent liver transplantation (LT). Patients undergoing LT exhibited significantly prolonged progression-free survival (PFS) compared to those with bridging-without-transplant (p = 0.033). No significant differences were observed between patients with bridging-without-transplant and palliative cases (p = 0.116). Median overall survival (OS) post-TARE was 16.6 months, with estimated OS rates at 6/12 months of 82.0%/60.5%, respectively. Patients who underwent LT demonstrated statistically significantly longer OS compared to those with bridging-without-transplant (p = 0.001). No marked outcome distinctions were found between bridging-without-transplant and palliative groups. The findings underscored the superiority of LT over alternative treatments. TARE served as an important component in non-LT scenarios, allowing for subsequent therapeutic options. The study reflected the highly variable and complex situations of patients with HCC, emphasizing the need for further investigations to define an optimal multimodal approach.

Keywords: bridging therapies; hepatocellular carcinoma; liver carcinoma; liver transplantation; radioembolization.

Grants and funding

This research received no external funding. Publication of the article received support from the German Research Foundation, project no. 512648189, and the Open Access Publication Fund of the Thueringer Universitaets- und Landesbibliothek Jena.