Purpose The management of Renal cell carcinoma (RCC) patients with liver metastases
is challenging. Liver-directed therapy, such as Transarterial radioembolization (TARE),
is a reasonable option for these patients; however, its safety and efficacy are not
well characterized. This study evaluated the safety and efficacy of TARE in patients
with liver-dominant metastatic RCC. Materials and Methods This is a retrospective,
single-center study. Thirty-eight patients' medical records were reviewed who underwent
TARE between January 1, 2009, and December 31, 2019, in a tertiary cancer center.
Two were excluded from further analysis. Thirty-six patients received 51 TARE treatments.
Median follow-up time was 18.2 months. Imaging data were evaluated using mRECIST or
RECIST 1.1 criteria. Toxicities, treatment responses, liver progression-free survival
(LPFS), and median overall survival (OS) were calculated. Univariate and multivariate
analyses were conducted to reveal predictors of OS. Results Median OS from TARE was
19.3 months (95% CI, 22.6-47.4) and from diagnosis of liver metastases was 36.5 months
(95% CI: 26.4-49.8). Mild, grade 1 or 2, biochemical toxicity developed in 27 patients
(75%). Grade 3-4 toxicity was noted in two patients (5.5%). The objective response
rate was 89%; the disease control rate was 94% (21 complete response, 11 partial response,
two stable disease, and two progressive disease). Univariate and multivariate analyses
showed longer survival in patients who had objective response, lower lung shunt fraction,
and better baseline liver function. Conclusions TARE is safe and effective and led
to promising overall survival in patients with liver-dominant metastatic RCC. Level
of Evidence: Level 3, retrospective cohort study.
