本研究旨在评估铒-90经肝动脉放射性栓塞治疗（TARE）对于最初无法手术切除的单个大型（≥ 5cm）肝细胞癌（HCC）的疗效。TARE可以缩小胆管癌以进行手术切除，但其在肝细胞癌（HCC）可切除性中的作用仍存在争议。回顾性调查了2015年至2020年期间在一家三级中心接受治疗的所有连续患有单个大型HCC的患者。如果有适应证，患者将直接接受手术切除（直接手术）或接受TARE。TARE患者可能会转为切除（TARE-手术组）或不转为切除（TARE-仅放射）治疗。为了进一步评估TARE对长期和短期结果的影响，进行了倾向性评分匹配（PSM）分析。在216名患者中，144名（66.7%）接受了直接手术。在72名TARE患者中，有20名（27.7%）转为切除手术。TARE-手术组患者接受的铒-90平均剂量高于其余的TARE-仅放射患者（211.89 Gy ± 107.98 vs. 128.7 Gy ± 36.52，P<0.001）。直接手术组与TARE-手术组患者的术后结果相似。在未匹配的人群中，直接手术组和TARE-手术组患者的1、3、5年总生存率相似（83.0%、60.0%、47.0% vs. 94.0%、86.0%、55.0%，P=0.43），并且与TARE-仅放射组相比表现出较好（61.0%、16.0%和9.0%，P<0.0001）。经过PSM分析，TARE-手术组的总生存率明显优于直接手术组（P=0.021），而无疾病生存期相似（P=0.29）。TARE可能是对于无法手术切除的局限性单个大型HCC的一种有效的分期治疗方法，其短期和长期结果与可手术切除的肿瘤相当。版权所有© 2023 Wolters Kluwer Health，Inc.保留所有权利。

The aim of this study was to evaluate the efficacy of Yttrium-90 Transarterial Radioembolization (TARE) to convert to resection initially unresectable, single, large (≥5 cm) hepatocellular carcinoma (HCC).TARE can downsize cholangiocarcinoma to resection but its role in hepatocellular carcinoma (HCC) resectability remains debatable.All consecutive patients with a single large HCC treated between 2015 and 2020 in a single tertiary centre were reviewed. When indicated, patients were either readily resected (Upfront-surgery) or underwent TARE. TARE patients were converted to resection (TARE-surgery) or not (TARE-only). To further assess the effect of TARE on the long and short-term outcomes, a propensity score matching (PSM) analysis was performed.Among 216 patients, 144 (66.7%) underwent upfront surgery. Among 72 TARE patients, 20 (27.7%) were converted to resection. TARE-surgery patients received a higher mean Yttrium-90 dose that the 52 remaining TARE-only patients (211.89 Gy ± 107.98 vs. 128.7 Gy ± 36.52, P<0.001). Post-operative outcomes between Upfront-surgery and TARE-surgery patients were similar. In the unmatched population, overall survival (OS) at 1, 3, and 5 years was similar between upfront-surgery and TARE-surgery patients (83.0%, 60.0%, 47% vs. 94.0%, 86.0%, 55.0%, P=0.43) and compared favourably with TARE-only patients (61.0%, 16.0% and 9.0%, P<0.0001). After PSM, TARE-surgery patients had significantly better OS than Upfront-surgery patients (P=0.021) while DFS was similar (P=0.29).TARE may be a useful downstaging treatment for unresectable localized single large HCC providing comparable short and long-term outcomes with readily resectable tumours.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.