1, 2 The coexistence of two life-threatening conditions such as cancer and cirrhosis makes it difficult to prognosticate the outcome of patients with HCC. The most used staging system is the Barcelona Clínic EX 527 Liver Cancer (BCLC), endorsed by both

American and European liver societies.2, 3 The intermediate stage of HCC (BCLC-B) incorporates heterogeneous tumor burdens and liver function stages (Child-Pugh class A or B) resulting in a wide interval of expected survival after trans-arterial chemoembolization (TACE), from 14 to 45 months.2 This suggests that not all intermediate-stage HCCs will derive a similar benefit from TACE, whereas some patients may benefit from other treatment options.4 In addition, patients with advanced HCC (BCLC-C stage), although sharing a median survival of less than a year, may present with heterogeneous see more performance statuses and different tumor burdens, from single nodules associated

with limited portal vein thrombosis (PVT) amenable of curative attempts to bulky intrahepatic diffusion associated with extrahepatic spread (EHS). In all those patients, sorafenib significantly improves survival,5 with subgroup analyses showing that different baseline characteristics may affect the expected survival. Yttrium-90 radioembolization (Y90RE) is a novel transarterial approach to radiation therapy for liver cancer that has achieved in large series comparable or improved MCE公司 survival, time-to-progression (TTP) and toxicity with respect to chemoembolization,6 and efficacious tumor control also in advanced

patients with PVT.7, 8 According to published data, Y90RE could compete favorably with TACE or sorafenib in the appropriate setting. However, no prospective phase 2 or 3 studies confirming Y90RE results have been reported, hindering such a technique from its application in general practice. The present phase 2 study was undertaken to assess the efficacy and safety of Y90RE—as for variations in TTP and overall survival (OS)—in a prospective cohort of intermediate and advanced HCC: namely, in a population of patients with well-compensated cirrhosis and cancer, associated or not with tumoral invasion of the portal system.