Combined Transarterial Chemoembolization and External Beam Radiotherapy for Identifying Surgical Candidates for Hepatocellular Carcinoma with Macroscopic Vascular Invasion: A Propensity Score-Weighted Analysis

• DOI: 10.4143/crt.2025.076
• Publication Date: 2025-05-22T06:20:33Z
• Authors: Sumin Lee; Jinhong Jung; Jonggi Choi; So Yeon Kim; Jin Hyoung Kim; Danbi Lee; Ju Hyun Shim; Kang Mo Kim; Young-Suk Lim; Han Chu Lee; Gi-Won Song; Jin-hong Park; Sang Min Yoon
• Keywords: External beam radiotherapy

To evaluate the role of hepatic resection in patients with objective responses after combined transarterial chemoembolization (TACE) and radiotherapy (RT) for hepatocellular carcinoma (HCC) macroscopic vascular invasion (MVI). We retrospectively reviewed treated TACE RT HCC MVI between 2010 2015. Some underwent or liver transplantation; to investigate impact surgery, who did not undergo surgery were selected as control group. Survival outcomes compared using a propensity score-based stabilized inverse probability treatment weighting method. Out 170 RT, 41 including 8 transplantations. The unweighted group was younger had higher proportion solitary tumors unilateral involvement. After adjustment, 3-year overall survival (OS) rates 61.0% 28.6% non-surgery groups, respectively. most important prognostic factor OS (adjusted Cox hazard ratio [HR], 0.28; 95% confidence interval [CI], 0.17-0.46; p<0.001). Complete response (vs. partial response) also significant HR, 0.41; CI, 0.27-0.61; There no surgical mortality. Four (9.8%) required additional due bleeding graft failure. Hepatic significantly associated improved showed receiving MVI.