Evidence map›Paper›PMID 42841937›Full record

ArticleEuropean radiology2026

Preoperative radioembolization versus chemoembolization and upfront resection for resectable hepatocellular carcinoma beyond the Milan criteria.

Jeayeon Park, Gyung Sun Lim, Yunmi Ko, Hyunjae Shin, Moon Haeng Hur, Su Young Hong, Suk Kyun Hong, Yun Bin Lee, Eun Ju Cho, Jeong-Hoon Lee and 8 more

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Article in European radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Jeayeon Park *Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Gyung Sun Lim *Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Yunmi KoDepartment of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Hyunjae ShinDepartment of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Moon Haeng HurDepartment of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Su Young HongDepartment of Surgery, Seoul National University, College of Medicine, Seoul, Republic of Korea.
Suk Kyun HongDepartment of Surgery, Seoul National University, College of Medicine, Seoul, Republic of Korea.
Yun Bin LeeDepartment of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Eun Ju ChoDepartment of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Jeong-Hoon LeeDepartment of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
YoungRok ChoiDepartment of Surgery, Seoul National University, College of Medicine, Seoul, Republic of Korea.
Su Jong YuDepartment of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Hyo-Cheol KimDepartment of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Kwang-Woong LeeDepartment of Surgery, Seoul National University, College of Medicine, Seoul, Republic of Korea.
Jung-Hwan YoonDepartment of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Kyung-Suk SuhDepartment of Surgery, Seoul National University, College of Medicine, Seoul, Republic of Korea.
Jin Wook ChungDepartment of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Yoon Jun KimDepartment of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. yoonjun@snu.ac.kr.ORCID http://orcid.org/0000-0001-9141-7773

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAs the role of transarterial radioembolization (TARE) in resectable hepatocellular carcinoma (HCC) beyond Milan criteria remains undefined, this study compared preoperative TARE and chemoembolization (TACE) with primary resection to establish the optimal management strategy. MATERIALS AND

methodsWe retrospectively analyzed HCC patients who did not meet the Milan criteria and underwent primary liver resection, preoperative TACE, or preoperative TARE. Overall survival (OS), time to recurrence (TTR), and recurrence-free survival (RFS) were analyzed using Kaplan-Meier estimates and Cox regression with inverse probability of treatment weighting (IPTW).

resultsA total of 226 patients were included (primary resection, n = 127; preoperative TACE, n = 52; preoperative TARE, n = 47), with a median follow-up of 37.2 months. After IPTW, baseline characteristics were well balanced. Median OS was not reached in the primary resection and preoperative TARE, but was 60.7 months in the preoperative TACE group. Compared with primary resection, preoperative TACE was associated with worse OS (adjusted HR [aHR]: 2.72; 95% confidence interval [CI] 1.39-5.33; p = 0.004), whereas OS with preoperative TARE was comparable (aHR: 1.14; 95% CI: 0.50-2.55; p = 0.76) after IPTW. Similarly, TTR and RFS were significantly worse in the preoperative TACE (both p = 0.02), whereas no significant differences were observed between the preoperative TARE and primary liver resection groups after IPTW (p = 0.59 and p = 0.57).

conclusionPreoperative TARE showed no significant difference in survival from primary liver resection in resectable HCC beyond the Milan criteria and may serve as a reasonable alternative strategy when upfront surgery is not feasible. KEY POINTS: Question Optimal treatment for resectable hepatocellular carcinoma (HCC) beyond the Milan criteria is controversial. The role of preoperative transarterial radioembolization (TARE) compared with chemoembolization (TACE) or upfront resection remains unclear. Findings Preoperative TARE achieved survival outcomes comparable to primary resection, whereas preoperative TACE was associated with significantly inferior overall and recurrence-free survival. Clinical relevance Preoperative TARE demonstrates survival outcomes comparable to primary resection. It serves as a reasonable therapeutic alternative for resectable hepatocellular carcinoma beyond the Milan criteria, offering effective local control when immediate surgery is not feasible.

Indexed as

HepatectomyLiver cancerLocoregional therapyMicrovascular invasionPreoperative treatment

Identifiers

PMID42841937

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.