ArticleHepatobiliary surgery and nutrition2023
Large, multifocal or portal vein-invading hepatocellular carcinoma (HCC) downstaged by Y90 using personalized dosimetry: safety, pathological results and outcomes after surgery.
Article in Hepatobiliary surgery and nutrition, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05045573 (Pathological Results After Downstaging of Agressive Hepatocellular Carcinoma Using 90Y-SIRT With Personalized Dosimetry), which is not on this map. Cited by 9 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Pathological Results After Downstaging of Agressive Hepatocellular Carcinoma Using 90Y-SIRT With Personalized Dosimetry
Who cites it
9 citing papers in PubMed, 17 citations in OpenAlex.
- Long-Term Overall Survival After Selective Internal Radiation Therapy for Locally Advanced Hepatocellular Carcinomas: Updated Analysis of DOSISPHERE-01 Trial.Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2024Trial
- Radiation segmentectomy for hepatocellular carcinoma: redefining the limits of curative-intent therapy.The British journal of radiology · 2026Review
- Histopathologic outcomes of hepatocellular carcinoma treated with transarterial radioembolization with yttrium-90 resin microspheres.European journal of nuclear medicine and molecular imaging · 2026Article
- Resection and yttrium-90 radioembolization as sequential downstaging to living donor liver transplantation for large, multifocal hepatocellular carcinoma with lobar portal vein tumor thrombosis.Hepatobiliary surgery and nutrition · 2025Article
- Article
- Yttrium-90 microsphere therapy for hepatocellular carcinoma: Clinical efficacy, mechanistic insights, and comparative therapeutic perspectives.World journal of gastrointestinal oncology · 2025Review
- Evaluating liver resection outcomes post Y90 TARE with personalized dosimetry in intermediate or advanced hepatocellular carcinoma: a focus on surgical and biliary complications.Hepatobiliary surgery and nutrition · 2025Article
- Research Progress in Predicting Hepatocellular Carcinoma with Portal Vein Tumour Thrombus in the Era of Artificial Intelligence.Journal of hepatocellular carcinoma · 2024Review
- Advances in the treatment of hepatocellular carcinoma: An overview of the current and evolving therapeutic landscape for clinicians.CA: a cancer journal for cliniciansReview
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Transarterial radioembolization (TARE) has recently been recognized as a bridging/downstaging therapy to surgery for early hepatocellular carcinomas (HCCs) with high rates of complete pathological necrosis (CPN) on liver explants. In patients with portal vein tumoral thrombus (PVTT), multifocal or large tumors, TARE has mainly a palliative role and surgery remains controversial in this poor-prognosis population. Personalized dosimetry recently proved to outperform standard dosimetry used in prior negative Y90 randomized-controlled trials. Methods: In this retrospective study, we evaluated safety, radiological and pathological response and outcomes in HCC patients with PVTT, multifocal or large tumors, who underwent surgery after downstaging using TARE with Y90-loaded glass microspheres with personalized dosimetry. Results: Between December 2015 and October 2021, 18 unresectable patients (14/18 with PVTT) had surgery (16 resections, 2 liver transplantations) 6.2 months (range, 2-14.6 months) after a single Y90 treatment. No 90-day mortality was reported. Objective modified response criteria in solid tumors (mRECIST) response were noted in all but one patient. Complete and extensive (50-99%) necrosis was observed in 36% and 45% of tumors, respectively. The post-treatment tumor-absorbed dose significantly differed depending on the extent of pathological necrosis (P=0.045). Median overall survival and progression-free survival (PFS) were respectively of 61.8 months [95% CI: 31.4 months-not reached (NR)] and 49.3 months (95% CI: 14 months-NR). PFS was longer in patients with complete imaging response [median NR (none recurred or died) Conclusions: Y90 TARE using personalized dosimetry can provide high rates of imaging and pathological response in patients with PVTT, large or multifocal HCC. Subsequent surgery is safe and leads to outcomes far exceeding expectations in an otherwise poor prognosis population with no chance for cure. Trial Registration: Clinical trial number: NCT05045573.
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