To compare the outcomes of yttrium-90 transarterial radioembolization (TARE) in patients with hepatocellular carcinoma (HCC) with and without macrotrabecular-massive (MTM) subtypes. Forty-one consecutive patients with HCC (male, 90.3%; mean age, 65.3 years [SD ± 10.7]) who underwent yttrium-90 TARE between September 2014 and January 2022 were grouped into the MTM-HCC (n = 17, 41.5%) and non–MTM-HCC (n = 24, 58.5%) groups based on their histopathological subtypes. Demographic, clinical, and radiological characteristics were compared. Survival, univariate, and multivariate analyses were performed, and prognostic factors were evaluated. In MTM-HCC group, the rates of moderately to poorly differentiated tumors were significantly higher (13/17 vs 8/16, = .007), and new intrahepatic/extrahepatic metastases were detected more frequently (12/17 vs 15/24, = .038). Median overall survival (OS) in the cohort was 29 months (range, 17.1–40.9 months), whereas patients with MTM-HCC had a significantly shorter median OS (20 vs 44 months, = .014). In univariate analysis, MTM-HCC subtype (hazard ratio [HR], 2.690; = .021), the presence of satellite nodules (HR, 3.810; = .004), and macrovascular invasion (HR, 3.321; = .012) were identified as significant prognostic factors. In multivariate analysis, MTM-HCC subtype and macrovascular invasion were determined as independent poor prognostic factors ( = .038 and = .012, respectively). In patients with HCC treated with yttrium-90 TARE, both the rates of moderately to poorly differentiated histopathological classes and the development of intrahepatic or extrahepatic metastases were significantly higher in the MTM subtype. OS was worse in patients with MTM-HCC, and macrovascular invasion and MTM-HCC subtype were identified as independent poor prognostic factors.

中文翻译：

---

钇 90 经动脉放射栓塞治疗大小梁-巨块-亚型肝细胞癌患者的结果

比较有和没有大小梁肿块 (MTM) 亚型的肝细胞癌 (HCC) 患者接受钇 90 经动脉放射栓塞 (TARE) 的结果。 2014 年 9 月至 2022 年 1 月期间接受钇 90 TARE 的 41 名连续 HCC 患者（男性，90.3%；平均年龄，65.3 岁 [SD ± 10.7]）被分为 MTM-HCC（n = 17，41.5%） ) 和非 MTM-HCC (n = 24, 58.5%) 组（基于其组织病理学亚型）。比较人口统计学、临床和放射学特征。进行了生存、单变量和多变量分析，并评估了预后因素。在MTM-HCC组中，中低分化肿瘤的发生率显着较高（13/17 vs 8/16，= .007），并且更频繁地检测到新的肝内/肝外转移（12/17 vs 15/24， =.038）。该队列中的中位总生存期 (OS) 为 29 个月（范围为 17.1–40.9 个月），而 MTM-HCC 患者的中位 OS 明显更短（20 个月与 44 个月，= 0.014）。在单变量分析中，MTM-HCC 亚型（风险比 [HR]，2.690；= .021）、卫星结节的存在（HR，3.810；= .004）和大血管侵犯（HR，3.321；= .012）被确定为重要的预后因素。在多变量分析中，MTM-HCC 亚型和大血管侵犯被确定为独立的不良预后因素（分别 = .038 和 = .012）。在接受钇-90 TARE 治疗的 HCC 患者中，MTM 亚型的中度至低度分化组织病理学类型的发生率以及肝内或肝外转移的发生率均显着较高。 MTM-HCC 患者的 OS 较差，大血管侵犯和 MTM-HCC 亚型被确定为独立的不良预后因素。