Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website https://gr.elmerpub.com

Original Article

Volume 18, Number 5, October 2025, pages 207-223

Risk Stratification and Contemporary Predictors of Survival in Hepatocellular Carcinoma Treated With Transarterial Radioembolization

↓ Figure 1. Impact of ICIs on the TARE-related OS in the study population. (a) ICI at any time in their lifetime (697 days) vs. never received ICI (226 days); (b) ICI before TARE (678 days) vs. ICI after TARE (703 days) vs. never received ICI (226 days). ICIs: immune checkpoint inhibitors; OS: overall survival; pre-TARE: ICI before TARE; post-TARE: ICI after TARE; TARE: transarterial radioembolization.

↓ Figure 2. Impact of ICIs on the OS in the study population. (a) ICI at any time in their lifetime (1,102 days) vs. never received ICI (614 days); (b) ICI before TARE (1,959 days) vs. ICI after TARE (927 days) vs. never received ICI (614 days). ICIs: immune checkpoint inhibitors; OS: overall survival; pre-TARE: ICI before TARE; post-TARE: ICI after TARE; TARE: transarterial radioembolization.

↓ Figure 3. Comparing PFS in patients based on the response noted in the first post-TARE imaging scan. Red indicates complete response, green indicates disease progression, blue indicates partial response, and yellow indicates ambiguous response. PFS: progression-free survival; TARE: transarterial radioembolization.

↓ **Table 1.** Baseline Characteristics of the Study Population (N = 141)
Characteristic	n (%)
^a24 patients had two-staged TAREs. ^bBefore first TARE. AFP: alpha-fetoprotein; DM: diabetes mellitus; HCC: hepatocellular carcinoma; HE: hepatic encephalopathy; ICI: immune checkpoint inhibitor; INR: international normalized ratio; MAFLD: metabolic-dysfunction-associated fatty liver disease; PVTT: portal vein tumor thrombus; SBRT: stereotactic body radiotherapy; TACE: transarterial chemoembolization; TARE: transarterial radioembolization; T bili: total bilirubin; TKI: tyrosine kinase inhibitor.
Median age of diagnosis	65 years (range 49 - 88)
Race
White	113 (80.14%)
African American	22 (15.60%)
Other	6 (4.26%)
Sex
Male	113 (80.14%)
Female	28 (19.86%)
History of hepatitis B infection	8 (5.67%)
History of hepatitis C infection	72 (51.06%)
History of alcoholic liver cirrhosis	110 (78.01%)
History of MAFLD	17 (12.06%)
History of DM	50 (35.46%)
Ascites at diagnosis	35 (24.82%)
HE at diagnosis	41 (29.08%)
Smoking history
Active	52 (37%)
Former	53 (38%)
Never	36 (25%)
Alcohol use
Active	52 (37%)
Never	65 (46%)
Former	24 (17%)
Number of TARE procedures
1	122 (87%)^a
2	17 (12%)
3	2 (1%)
Therapy before TARE
None	50 (35.46%)
TACE	59 (41.84%)
Ablation	35 (24.82%)
Surgery	18 (12.77%)
SBRT	7 (4.97%)
Systemic therapy	12 (8.52%)
Number of HCC lesions
1	65 (46.10%)
2	30 (21.28%)
3	16 (11.35%)
> 3	30 (21.28%)
Size of HCC lesions
≤ 3 cm	56 (40%)
> 3 cm	79 (56%)
Not measurable	6 (4%)
HCC in liver lobes
Right lobe	66 (46.81%)
Both lobes	47 (33.33%)
Left lobe	23 (16.31%)
Undefined	5 (3.55%)
PVTT
None	107 (75.89%)
Main portal vein	14 (9.93%)
Right portal vein	9 (6.38%)
Present but location is unclear	7 (4.97%)
Left portal vein	4 (2.84%)
Child-Pugh score
A	105 (74.47%)
B	34 (24.11%)
C	2 (1.42%)
Baseline^b T bili (mg/dL; median/mean)	1/1.05
Baseline^b albumin (g/dL; median/mean)	4/3.76
Baseline^b INR (median/mean)	1/1.09
Baseline^b AFP (ng/dL; median/mean)	26.5 (1 - 78,314)/1,688.10
TKI use
No	107 (76%)
Post-TARE	29 (21%)
Pre-TARE	5 (3%)
TKI drugs used
Sorafenib	21 (14.89%)
Lenvatinib	16 (11.35%)
Cabozantinib	2 (1.42%)
ICI use
No-ICI group	102 (72.34%)
Post-TARE ICI group	34 (24.11%)
Pre-TARE ICI group	5 (3.55%)
ICI drugs used
Nivolumab	19 (49%)
Atezolizumab and bevacizumab	20 (51%)

↓ Table 1. Baseline Characteristics of the Study Population (N = 141)

Characteristic

n (%)

^a24 patients had two-staged TAREs. ^bBefore first TARE. AFP: alpha-fetoprotein; DM: diabetes mellitus; HCC: hepatocellular carcinoma; HE: hepatic encephalopathy; ICI: immune checkpoint inhibitor; INR: international normalized ratio; MAFLD: metabolic-dysfunction-associated fatty liver disease; PVTT: portal vein tumor thrombus; SBRT: stereotactic body radiotherapy; TACE: transarterial chemoembolization; TARE: transarterial radioembolization; T bili: total bilirubin; TKI: tyrosine kinase inhibitor.

Median age of diagnosis

65 years (range 49 - 88)

Race

White

113 (80.14%)

African American

22 (15.60%)

Other

6 (4.26%)

Sex

Male

113 (80.14%)

Female

28 (19.86%)

History of hepatitis B infection

8 (5.67%)

History of hepatitis C infection

72 (51.06%)

History of alcoholic liver cirrhosis

110 (78.01%)

History of MAFLD

17 (12.06%)

History of DM

50 (35.46%)

Ascites at diagnosis

35 (24.82%)

HE at diagnosis

41 (29.08%)

Smoking history

Active

52 (37%)

Former

53 (38%)

Never

36 (25%)

Alcohol use

Active

52 (37%)

Never

65 (46%)

Former

24 (17%)

Number of TARE procedures

122 (87%)^a

17 (12%)

2 (1%)

Therapy before TARE

None

50 (35.46%)

TACE

59 (41.84%)

Ablation

35 (24.82%)

Surgery

18 (12.77%)

SBRT

7 (4.97%)

Systemic therapy

12 (8.52%)

Number of HCC lesions

65 (46.10%)

30 (21.28%)

16 (11.35%)

> 3

30 (21.28%)

Size of HCC lesions

≤ 3 cm

56 (40%)

> 3 cm

79 (56%)

Not measurable

6 (4%)

HCC in liver lobes

Right lobe

66 (46.81%)

Both lobes

47 (33.33%)

Left lobe

23 (16.31%)

Undefined

5 (3.55%)

PVTT

None

107 (75.89%)

Main portal vein

14 (9.93%)

Right portal vein

9 (6.38%)

Present but location is unclear

7 (4.97%)

Left portal vein

4 (2.84%)

Child-Pugh score

105 (74.47%)

34 (24.11%)

2 (1.42%)

Baseline^b T bili (mg/dL; median/mean)

1/1.05

Baseline^b albumin (g/dL; median/mean)

4/3.76

Baseline^b INR (median/mean)

1/1.09

Baseline^b AFP (ng/dL; median/mean)

26.5 (1 - 78,314)/1,688.10

TKI use

107 (76%)

Post-TARE

29 (21%)

Pre-TARE

5 (3%)

TKI drugs used

Sorafenib

21 (14.89%)

Lenvatinib

16 (11.35%)

Cabozantinib

2 (1.42%)

ICI use

No-ICI group

102 (72.34%)

Post-TARE ICI group

34 (24.11%)

Pre-TARE ICI group

5 (3.55%)

ICI drugs used

Nivolumab

19 (49%)

Atezolizumab and bevacizumab

20 (51%)

↓ **Table 2.** Factors Impacting PFS in the Study Population Treated With TARE
Factor	Univariate	Multivariate
^aBaseline: before TARE. *Significant P values. CI: confidence interval; HE: hepatic encephalopathy; HR: hazard ratio; ICI: immune checkpoint inhibitor; MAFLD: metabolic-dysfunction-associated fatty liver disease; PVTT: portal vein tumor thrombus; SBRT: stereotactic body radiotherapy; TACE: transarterial chemoembolization; TARE: transarterial radioembolization.
ICI used before TARE
No	-	-	-	-	-	-
Yes	0.64	0.26 - 1.58	0.3	0.90	0.32 - 2.51	0.8
Age at diagnosis	0.99	0.97 - 1.02	0.6	0.99	0.97 - 1.02	0.7
Race
White	-	-	-	-	-	-
African American/Black	0.86	0.53 - 1.39	0.5	0.94	0.54 - 1.65	0.8
Other	0.59	0.22 - 1.61	0.3	0.45	0.15 - 1.34	0.2
Hepatitis C
No	-	-	-	-	-	-
Yes	0.91	0.65 - 1.29	0.6	0.98	0.62 - 1.55	>0.9
MAFLD
No	-	-	-	-	-	-
Yes	1.64	0.98 - 2.76	0.061	1.56	0.84 - 2.89	0.2
SBRT
No	-	-	-	-	-	-
Yes	1.05	0.59 - 1.87	0.9	0.97	0.52 - 1.82	> 0.9
TACE
No	-	-	-	-	-	-
Yes	1.38	0.96 - 2.00	0.081	1.40	0.91 - 2.15	0.13
Number of lesions
Single	-	-	-	-	-	-
> 1	1.24	0.87 - 1.75	0.2	1.12	0.76 - 1.64	0.6
Size of the lesions
≤ 3 cm	-	-	-	-	-	-
> 3 cm or not measurable	1.20	0.84 - 1.71	0.3	1.22	0.82 - 1.79	0.3
Baseline^a total bilirubin	0.97	0.75 - 1.25	0.8	0.70	0.50 - 0.97	0.034*
Baseline^a albumin	0.63	0.48 - 0.84	0.002*	0.58	0.40 - 0.85	0.005*
Active smoking
No	-	-	-	-	-	-
Yes	0.97	0.68 - 1.39	0.9	0.89	0.59 - 1.33	0.6
Active alcohol
No	-	-	-	-	-	-
Yes	1.15	0.80 - 1.64	0.5	1.28	0.85 - 1.91	0.2
Ascites
No	-	-	-	-	-	-
Yes	1.54	1.03 - 2.28	0.034*	1.36	0.82 - 2.24	0.2
HE
No	-	-	-	-	-	-
Yes	1.46	1.00 - 2.12	0.048*	1.29	0.84 - 1.96	0.2
PVTT - absent vs. present
Absent	-	-	-	-	-	-
Present	0.72	0.47 - 1.09	0.12	0.83	0.51 - 1.35	0.4
PVTT - specific
None	-	-	-	-	-	-
Left portal vein	0.22	0.05 - 0.92	0.038*	-	-	-
Main portal vein	0.87	0.48 - 1.55	0.6	-	-	-
Present, but the location is unclear	1.29	0.57 - 2.96	0.5	-	-	-
Right portal vein	0.66	0.32 - 1.36	0.3	-	-	-

↓ Table 2. Factors Impacting PFS in the Study Population Treated With TARE

Factor

Univariate

Multivariate

95% CI

P-value

Adjusted HR

95% CI

P-value

^aBaseline: before TARE. *Significant P values. CI: confidence interval; HE: hepatic encephalopathy; HR: hazard ratio; ICI: immune checkpoint inhibitor; MAFLD: metabolic-dysfunction-associated fatty liver disease; PVTT: portal vein tumor thrombus; SBRT: stereotactic body radiotherapy; TACE: transarterial chemoembolization; TARE: transarterial radioembolization.

ICI used before TARE

Yes

0.64

0.26 - 1.58

0.3

0.90

0.32 - 2.51

0.8

Age at diagnosis

0.99

0.97 - 1.02

0.6

0.99

0.97 - 1.02

0.7

Race

White

African American/Black

0.86

0.53 - 1.39

0.5

0.94

0.54 - 1.65

0.8

Other

0.59

0.22 - 1.61

0.3

0.45

0.15 - 1.34

0.2

Hepatitis C

Yes

0.91

0.65 - 1.29

0.6

0.98

0.62 - 1.55

>0.9

MAFLD

Yes

1.64

0.98 - 2.76

0.061

1.56

0.84 - 2.89

0.2

SBRT

Yes

1.05

0.59 - 1.87

0.9

0.97

0.52 - 1.82

> 0.9

TACE

Yes

1.38

0.96 - 2.00

0.081

1.40

0.91 - 2.15

0.13

Number of lesions

Single

> 1

1.24

0.87 - 1.75

0.2

1.12

0.76 - 1.64

0.6

Size of the lesions

≤ 3 cm

> 3 cm or not measurable

1.20

0.84 - 1.71

0.3

1.22

0.82 - 1.79

0.3

Baseline^a total bilirubin

0.97

0.75 - 1.25

0.8

0.70

0.50 - 0.97

0.034*

Baseline^a albumin

0.63

0.48 - 0.84

0.002*

0.58

0.40 - 0.85

0.005*

Active smoking

Yes

0.97

0.68 - 1.39

0.9

0.89

0.59 - 1.33

0.6

Active alcohol

Yes

1.15

0.80 - 1.64

0.5

1.28

0.85 - 1.91

0.2

Ascites

Yes

1.54

1.03 - 2.28

0.034*

1.36

0.82 - 2.24

0.2

Yes

1.46

1.00 - 2.12

0.048*

1.29

0.84 - 1.96

0.2

PVTT - absent vs. present

Absent

Present

0.72

0.47 - 1.09

0.12

0.83

0.51 - 1.35

0.4

PVTT - specific

None

Left portal vein

0.22

0.05 - 0.92

0.038*

Main portal vein

0.87

0.48 - 1.55

0.6

Present, but the location is unclear

1.29

0.57 - 2.96

0.5

Right portal vein

0.66

0.32 - 1.36

0.3

↓ **Table 3.** Factors Impacting TARE-Specific OS in the Study Population
Factor	Univariate	Multivariate
^aBaseline: before TARE. *Significant P values. CI: confidence interval; HE: hepatic encephalopathy; HR: hazard ratio; ICI: immune checkpoint inhibitor; MAFLD: metabolic-dysfunction-associated fatty liver disease; PVTT: portal vein tumor thrombus; SBRT: stereotactic body radiotherapy; TACE: transarterial chemoembolization; TARE: transarterial radioembolization.
ICI use
No	-	-	-	-	-	-
Pre-TARE	0.42	0.15 - 1.16	0.10	0.61	0.17 - 2.18	0.6
Post-TARE	0.50	0.32 - 0.78	0.002*	0.37	0.23 - 0.61	< 0.001*
Age at diagnosis	1.00	0.98 - 1.02	> 0.9	1.01	0.98 - 1.04	0.6
Race
White	-	-	-	-	-	-
African American/Black	0.78	0.47 - 1.30	0.3	0.84	0.47 - 1.50	0.6
Other	0.70	0.26 - 1.92	0.5	0.63	0.20 - 1.96	0.4
Hepatitis C
No	-	-	-	-	-	-
Yes	0.93	0.65 - 1.34	0.7	1.03	0.64 - 1.67	0.9
MAFLD
No	-	-	-	-	-	-
Yes	1.86	1.09 - 3.19	0.023*	2.13	1.10 - 4.13	0.026*
SBRT
No	-	-	-	-	-	-
Yes	0.66	0.34 - 1.26	0.2	0.63	0.30 - 1.34	0.2
TACE
No	-	-	-	-	-	-
Yes	1.20	0.82 - 1.75	0.3	1.28	0.78 - 2.11	0.3
Number of lesions
Single	-	-	-	-	-	-
Multiple	1.35	0.93 - 1.95	0.11	1.29	0.85 - 1.95	0.2
Size of the lesions
≤ 3 cm	-	-	-	-	-	-
> 3 cm or not measurable	0.98	0.88 - 1.42	> 0.9	0.96	0.82 - 1.49	0.9
Baseline^a total bilirubin	1.18	0.92 - 1.52	0.2	0.85	0.61 - 1.18	0.3
Baseline^a albumin	0.62	0.47 - 0.82	< 0.001*	0.55	0.38 - 0.80	0.002*
Active smoking
No	-	-	-	-	-	-
Yes	1.19	0.82 - 1.74	0.4	1.05	0.67 - 1.63	0.8
Active alcohol
No	-	-	-	-	-	-
Yes	1.04	0.71 - 1.53	0.8	1.28	0.83 - 1.96	0.3
Ascites
No	-	-	-	-	-	-
Yes	1.86	1.23 - 2.81	0.003*	1.54	0.89 - 2.66	0.13
HE
No	-	-	-	-	-	-
Yes	2.10	1.43 - 3.09	< 0.001*	2.40	1.49 - 3.88	< 0.001*
Surgery
No	-	-	-	-	-	-
Yes	0.81	0.47 - 1.39	0.4	1.21	0.62 - 2.37	0.6
Ablation
No	-	-	-	-	-	-
Yes	1.00	0.67 - 1.48	> 0.9	0.91	0.55 - 1.49	0.7
PVTT - absent vs. present
Absent	-	-	-	-	-	-
Present	0.69	0.44 - 1.07	0.10	0.71	0.41 - 1.25	0.2
PVTT - specific vein
None	-	-	-	-	-	-
Left portal vein	0.21	0.05 - 0.87	0.031*	-	-	-
Main portal vein	1.22	0.66 - 2.19	0.5	-	-	-
Present, but location is unclear	0.53	0.17 - 1.67	0.3	-	-	-
Right portal Vein	0.63	0.29 - 1.37	0.2	-	-	-

↓ Table 3. Factors Impacting TARE-Specific OS in the Study Population

Factor

Univariate

Multivariate

95% CI

P-value

Adjusted HR

95% CI

P-value

ICI use

Pre-TARE

0.42

0.15 - 1.16

0.10

0.61

0.17 - 2.18

0.6

Post-TARE

0.50

0.32 - 0.78

0.002*

0.37

0.23 - 0.61

< 0.001*

Age at diagnosis

1.00

0.98 - 1.02

> 0.9

1.01

0.98 - 1.04

0.6

Race

White

African American/Black

0.78

0.47 - 1.30

0.3

0.84

0.47 - 1.50

0.6

Other

0.70

0.26 - 1.92

0.5

0.63

0.20 - 1.96

0.4

Hepatitis C

Yes

0.93

0.65 - 1.34

0.7

1.03

0.64 - 1.67

0.9

MAFLD

Yes

1.86

1.09 - 3.19

0.023*

2.13

1.10 - 4.13

0.026*

SBRT

Yes

0.66

0.34 - 1.26

0.2

0.63

0.30 - 1.34

0.2

TACE

Yes

1.20

0.82 - 1.75

0.3

1.28

0.78 - 2.11

0.3

Number of lesions

Single

Multiple

1.35

0.93 - 1.95

0.11

1.29

0.85 - 1.95

0.2

Size of the lesions

≤ 3 cm

> 3 cm or not measurable

0.98

0.88 - 1.42

> 0.9

0.96

0.82 - 1.49

0.9

Baseline^a total bilirubin

1.18

0.92 - 1.52

0.2

0.85

0.61 - 1.18

0.3

Baseline^a albumin

0.62

0.47 - 0.82

< 0.001*

0.55

0.38 - 0.80

0.002*

Active smoking

Yes

1.19

0.82 - 1.74

0.4

1.05

0.67 - 1.63

0.8

Active alcohol

Yes

1.04

0.71 - 1.53

0.8

1.28

0.83 - 1.96

0.3

Ascites

Yes

1.86

1.23 - 2.81

0.003*

1.54

0.89 - 2.66

0.13

Yes

2.10

1.43 - 3.09

< 0.001*

2.40

1.49 - 3.88

< 0.001*

Surgery

Yes

0.81

0.47 - 1.39

0.4

1.21

0.62 - 2.37

0.6

Ablation

Yes

1.00

0.67 - 1.48

> 0.9

0.91

0.55 - 1.49

0.7

PVTT - absent vs. present

Absent

Present

0.69

0.44 - 1.07

0.10

0.71

0.41 - 1.25

0.2

PVTT - specific vein

None

Left portal vein

0.21

0.05 - 0.87

0.031*

Main portal vein

1.22

0.66 - 2.19

0.5

Present, but location is unclear

0.53

0.17 - 1.67

0.3

Right portal Vein

0.63

0.29 - 1.37

0.2

↓ **Table 4.** Factors Impacting OS in the Study Population
Factor	Univariate	Multivariate
^aBaseline: before TARE. *Significant P values. CI: confidence interval; HE: hepatic encephalopathy; HR: hazard ratio; ICI: immune checkpoint inhibitor; MAFLD: metabolic-dysfunction-associated fatty liver disease; OS: overall survival; PVTT: portal vein tumor thrombus; SBRT: stereotactic body radiotherapy; TACE: transarterial chemoembolization; TARE: transarterial radioembolization.
ICI use
No	-	-	-	-	-	-
Yes - pre-TARE	0.39	0.14 - 1.07	0.067	0.92	0.28 - 3.33	> 0.9
Yes - post-TARE	0.65	0.42 - 1.02	0.059	0.67	0.42 - 1.07	0.090
Age of diagnosis	1.01	0.99 - 1.04	0.2	1.01	0.98 - 1.04	0.4
Race
White	-	-	-	-	-	-
African American/Black	0.71	0.43 - 1.18	0.2	0.81	0.44 - 1.48	0.5
Other	0.54	0.20 - 1.47	0.2	0.51	0.15 - 1.67	0.3
Hepatitis C
No	-	-	-	-	-	-
Yes	0.68	0.47 - 0.99	0.043*	0.75	0.43 - 1.31	0.3
MAFLD
No	-	-	-	-	-	-
Yes	2.23	1.30 - 3.83	0.004	1.86	0.92 - 3.73	0.082*
SBRT
No	-	-	-	-	-	-
Yes	0.67	0.35 - 1.29	0.2	0.55	0.26 - 1.15	0.11
TACE
No	-	-	-	-	-	-
Yes	0.77	0.53 - 1.13	0.2	1.13	0.70 - 1.81	0.6
Number of lesions
Single	-	-	-	-	-	-
Multiple	1.32	0.91 - 1.91	0.14	1.08	0.71 - 1.64	0.7
Size of the lesions
≤ 3 cm	-	-	-	-	-	-
> 3 cm or multiple	1.27	0.87 - 1.85	0.2	1.08	0.68 - 1.72	0.7
Baseline^a total bilirubin	1.17	0.88 - 1.55	0.3	0.90	0.65 - 1.25	0.5
Baseline^a albumin	0.71	0.54 - 0.94	0.016*	0.63	0.43 - 0.93	0.019*
Active smoking
No	-	-	-	-	-	-
Yes	0.95	0.65 - 1.38	0.8	1.09	0.69 - 1.74	0.7
Active alcohol
No	-	-	-	-	-	-
Yes	1.04	0.71 - 1.52	0.9	1.27	0.83 - 1.95	0.3
Ascites
No	-	-	-	-	-	-
Yes	1.75	1.16 - 2.64	0.008*	1.71	0.97 - 3.04	0.065*
HE
No	-	-	-	-	-	-
Yes	1.61	1.09 - 2.36	0.016*	2.01	1.22 - 3.32	0.006*
BMI	1.03	1.00 - 1.06	0.067	1.01	0.97 - 1.05	0.7
Line of TARE used
First	-	-	-	-	-	-
> 1	0.70	0.48 - 1.03	0.069	0.73	0.41 - 1.30	0.3
Surgery
No	-	-	-	-	-	-
Yes	0.56	0.32 - 0.97	0.038*	0.83	0.42 - 1.65	0.6
Ablation
No	-	-	-	-	-	-
Yes	0.50	0.33 - 0.75	< 0.001*	0.35	0.21 - 0.59	< 0.001*
PVTT
None	-	-	-	-	-	-
Present	1.06	0.70 - 1.69	0.7	0.72	0.39 - 1.35	0.3

↓ Table 4. Factors Impacting OS in the Study Population

Factor

Univariate

Multivariate

95% CI

P-value

Adjusted HR

95% CI

P-value

^aBaseline: before TARE. *Significant P values. CI: confidence interval; HE: hepatic encephalopathy; HR: hazard ratio; ICI: immune checkpoint inhibitor; MAFLD: metabolic-dysfunction-associated fatty liver disease; OS: overall survival; PVTT: portal vein tumor thrombus; SBRT: stereotactic body radiotherapy; TACE: transarterial chemoembolization; TARE: transarterial radioembolization.

ICI use

Yes - pre-TARE

0.39

0.14 - 1.07

0.067

0.92

0.28 - 3.33

> 0.9

Yes - post-TARE

0.65

0.42 - 1.02

0.059

0.67

0.42 - 1.07

0.090

Age of diagnosis

1.01

0.99 - 1.04

0.2

1.01

0.98 - 1.04

0.4

Race

White

African American/Black

0.71

0.43 - 1.18

0.2

0.81

0.44 - 1.48

0.5

Other

0.54

0.20 - 1.47

0.2

0.51

0.15 - 1.67

0.3

Hepatitis C

Yes

0.68

0.47 - 0.99

0.043*

0.75

0.43 - 1.31

0.3

MAFLD

Yes

2.23

1.30 - 3.83

0.004

1.86

0.92 - 3.73

0.082*

SBRT

Yes

0.67

0.35 - 1.29

0.2

0.55

0.26 - 1.15

0.11

TACE

Yes

0.77

0.53 - 1.13

0.2

1.13

0.70 - 1.81

0.6

Number of lesions

Single

Multiple

1.32

0.91 - 1.91

0.14

1.08

0.71 - 1.64

0.7

Size of the lesions

≤ 3 cm

> 3 cm or multiple

1.27

0.87 - 1.85

0.2

1.08

0.68 - 1.72

0.7

Baseline^a total bilirubin

1.17

0.88 - 1.55

0.3

0.90

0.65 - 1.25

0.5

Baseline^a albumin

0.71

0.54 - 0.94

0.016*

0.63

0.43 - 0.93

0.019*

Active smoking

Yes

0.95

0.65 - 1.38

0.8

1.09

0.69 - 1.74

0.7

Active alcohol

Yes

1.04

0.71 - 1.52

0.9

1.27

0.83 - 1.95

0.3

Ascites

Yes

1.75

1.16 - 2.64

0.008*

1.71

0.97 - 3.04

0.065*

Yes

1.61

1.09 - 2.36

0.016*

2.01

1.22 - 3.32

0.006*

BMI

1.03

1.00 - 1.06

0.067

1.01

0.97 - 1.05

0.7

Line of TARE used

First

> 1

0.70

0.48 - 1.03

0.069

0.73

0.41 - 1.30

0.3

Surgery

Yes

0.56

0.32 - 0.97

0.038*

0.83

0.42 - 1.65

0.6

Ablation

Yes

0.50

0.33 - 0.75

< 0.001*

0.35

0.21 - 0.59

< 0.001*

PVTT

None

Present

1.06

0.70 - 1.69

0.7

0.72

0.39 - 1.35

0.3

↓ **Table 5.** Impact of TARE on Liver Function
	Mean difference	Lower	Upper	P-value
TARE: transarterial radioembolization.
Albumin	0.53	0.42	0.63	< 0.0001
Total bilirubin	-0.91	-1.29	-0.53	< 0.0001
Child-Pugh score	-1.36	-1.63	-1.09	< 0.0001

↓ Table 5. Impact of TARE on Liver Function

Mean difference

Lower

Upper

P-value

TARE: transarterial radioembolization.

Albumin

0.53

0.42

0.63

< 0.0001

Total bilirubin

-0.91

-1.29

-0.53

< 0.0001

Child-Pugh score

-1.36

-1.63

-1.09

< 0.0001

↓ **Table 6.** Factors Influencing Survival in HCC Patients Treated With TARE in Our Study
	PFS	OS-TARE	OS
^aHas a trend toward significance with a P-value of 0.05 to 0.08. HE: hepatic encephalopathy; ICI: immune checkpoint inhibitor; MAFLD: metabolic-dysfunction-associated fatty liver disease; OS: overall survival; OS-TARE: TARE-specific OS; PFS: progression-free survival; PVTT: portal vein tumor thrombus; TARE: transarterial radioembolization.
Multivariate analysis
Better survival	High albumin	High albumin Post-TARE ICI	High albumin Prior ablation
Poor survival	Low total bilirubin	HE MAFLD	HE MAFLD^a Ascites^a
Univariate analysis
Better survival	High albumin Left vein PVTT	Post-TARE ICI High albumin No PVTT	Albumin Prior surgery or ablation Hepatitis C
Poor survival	MAFLD^a HE	MAFLD HE	Ascites HE

↓ Table 6. Factors Influencing Survival in HCC Patients Treated With TARE in Our Study

PFS

OS-TARE

^aHas a trend toward significance with a P-value of 0.05 to 0.08. HE: hepatic encephalopathy; ICI: immune checkpoint inhibitor; MAFLD: metabolic-dysfunction-associated fatty liver disease; OS: overall survival; OS-TARE: TARE-specific OS; PFS: progression-free survival; PVTT: portal vein tumor thrombus; TARE: transarterial radioembolization.

Multivariate analysis

Better survival

High albumin

High albumin
Post-TARE ICI

High albumin
Prior ablation

Poor survival

Low total bilirubin

HE
MAFLD

HE
MAFLD^a
Ascites^a

Univariate analysis

Better survival

High albumin
Left vein PVTT

Post-TARE ICI
High albumin
No PVTT

Albumin
Prior surgery or ablation Hepatitis C

Poor survival

MAFLD^a
HE

MAFLD
HE

Ascites
HE