Review
Copyright ©The Author(s) 2022.
World J Hepatol. May 27, 2022; 14(5): 885-895
Published online May 27, 2022. doi: 10.4254/wjh.v14.i5.885
Table 1 Outcomes for curative-intent therapies in hepatocellular carcinoma within Milan criteria
Modality
Overall survival at 5 yr (%)
Local tumor progression at 2 yr (%)
Local tumor progression at 5 yr (%)
Disease-free survival at 5 yr (%)
Transplant≥ 70[21]NDACumulative recurrence < 15[22]> 70[23]
Resection60-80[24-26]NDAResection margin recurrence 1-7[27-29]38-54[26,27,30]
Ablation ≤ 3 cm44-69[13,25,31]2-16[28,29,32]9.7-22[13,33,34]14-46[25,27]
TARE ≤ 3 cm75[35]2.4-6.1[36,37]NDANDA
Ablation ≤ 5 cm49-72[27,38,39]6-9[40,41]3-14[12,31,40]50-59[27,40]
TARE ≤ 5 cm57[35]6.1-10[37,42]28 for ≤ 5 cm[35]NDA
Table 2 Comparing key features of the LEGACY study and DOSISPHERE trial

LEGACY
DOSISPHERE
Study designMulti-center single-arm retrospective studyMulticenter randomized control phase ii trial
ObjectiveTo assess clinical outcomes of Y-90 glass microsphere treatment in patients with unresectable solitary HCC lesionsTo compare clinical outcomes of lobar TARE using 120 Gy (SDA) versus > 205 Gy (PDA) in patients with intermediate/advanced HCC
Inclusion criteriaUnresectable solitary lesions (≤ 8 cm); BCLC A or C (ECOG 0-1); Child-Pugh score A≥ 1 unresectable lesion ≥ 7 cm; BCLC A, B, or C
Exclusion criteriaPatients with vascular or extrahepatic disease, significant ascites, encephalopathy, or prior LRT, LT, resection, or systemic therapyPatients with micro-aggregate albumin (MAA) studies demonstrating poor tumor targeting
Overall survivalAt 3 yr, 86.6% for patients treated with TARE alone (median dose 410 Gy) and 92.8% for patients who down-staged via TAREOverall survival was improved in the personalized dosimetry group (26.6 mo vs 10.7 mo)
Downstaging21% successfully down-staged to LT; 6.8% to resection.36% patients in the PDA group and 3.5% (1/28) in the SDA group down-staged to resection1