%0 Journal Article %A Jihye Kim %A Ju Yeon Kim %A Jeong-Hoon Lee %A Dong Hyun Sinn %A Moon Haeng Hur %A Ji Hoon Hong %A Min Kyung Park %A Hee Jin Cho %A Na Ryung Choi %A Yun Bin Lee %A Eun Ju Cho %A Su Jong Yu %A Yoon Jun Kim %A Jin Chul Paeng %A Hyo Cheol Kim %A Nam-Joon Yi %A Kwang-Woong Lee %A Kyung-Suk Suh %A Dongho Hyun %A Jong Man Kim %A Jung-Hwan Yoon %T Long-Term Outcomes of Transarterial Radioembolization for Large Single Hepatocellular Carcinoma: A Comparison to Resection %D 2021 %R 10.2967/jnumed.121.263147 %J Journal of Nuclear Medicine %P jnumed.121.263147 %X The surgical treatment for large hepatocellular carcinoma (HCC) remains controversial due to a high risk of recurrence after resection. This study aimed to compare long-term outcomes of transarterial radioembolization (TARE) with resection for patients with large HCC. Methods: This retrospective cohort study included a total of 557 patients who were initially treated with either resection (the resection group, n = 500) or TARE (the TARE group, n = 57) for large (≥5 cm) single nodular HCC at two tertiary centers in Korea. Patients with major portal vein tumor thrombosis or extrahepatic metastasis were excluded. The primary endpoint was overall survival (OS), and secondary endpoints were time to progression (TTP), time to intrahepatic progression (TTIP), and safety. Results: The resection group were younger (median, 60 years vs. 69 years) with smaller tumor size (median, 7.0 cm vs. 10.0 cm) (all P<0.05). After baseline characteristics were balanced using inverse probability of treatment weighting (IPTW), the TARE group showed comparable OS (hazard ratio [HR], 0.98; 95% confidence interval [CI], 0.40–2.43; P = 0.97), TTP (HR, 1.10; 95% CI, 0.55–2.20; P = 0.80), and TTIP (HR, 1.45; 95% CI, 0.72–2.93; P = 0.30) to the resection group. TARE was not an independent risk for OS (adjusted-HR, 1.04; 95% CI, 0.42–2.59; P = 0.93), TTP (adjusted-HR, 0.98; 95% CI, 0.50–1.95; P = 0.96), or TTIP (adjusted-HR, 1.30; 95% CI, 0.65–2.58; P = 0.46). The TARE group showed shorter hospital stay and fewer adverse events than the resection group. Conclusion: TARE showed comparable OS, TTP, and TTIP with better safety profile compared to surgical resection for large single nodular HCC. %U https://jnm.snmjournals.org/content/jnumed/early/2021/12/09/jnumed.121.263147.full.pdf