Clinical outcomes of Y90 radioembolization for recurrent hepatocellular carcinoma following curative resection.

Abstract

PURPOSE:

To assess safety/efficacy of yttrium-90 radioembolization (Y90) in patients with recurrent hepatocellular carcinoma (HCC) following curative surgical resection.

METHODS:

With IRB approval, we searched our prospectively acquired database for patients that were treated with Y90 for recurrent disease following resection. Baseline characteristics and bilirubin toxicities following Y90 were evaluated. Intention-to-treat overall survival (OS) and time-to-progression (TTP) from Y90 were assessed.

RESULTS:

Forty-one patients met study inclusion criteria. Twenty-six (63%) patients had undergone minor (≤3 hepatic segments) resection while 15 (37%) patients underwent major (>3 hepatic segments) resections. Two patients (5%) had biliary-enteric anastomoses created during surgical resection. The median time from HCC resection to the first radioembolization was 17 months (95% CI: 13-37). The median number of Y90 treatment sessions was 1 (range: 1-5). Ten patients received (entire remnant) lobar Y90 treatment while 31 patients received selective (≤2 hepatic segments) treatment. Grades 1/2/3/4 bilirubin toxicity were seen in nine (22%), four (10%), four (10%), and zero (0%) patients following Y90. No differences in bilirubin toxicities were identified when comparing lobar with selective approaches (P = 0.20). No post-Y90 infectious complications were identified. Median TTP and OS were 11.3 (CI: 6.5-15.5) and 22.1 months (CI: 10.3-31.3), respectively.

CONCLUSIONS:

Radioembolization is a safe and effective method for treating recurrent HCC following surgical resection, with prolonged TTP and promising survival outcomes.

• Authors: Rehan Ali, Ahsun Riaz, Ahmed Gabr, Nadine Abouchaleh, Ronald Mora, Ali Al Asadi, Juan Carlos Caicedo, Michael Abecassis, Nitin Katariya, Haripriya Maddur, Laura Kulik, Robert J Lewandowski, Riad Salem
• Journal: European journal of nuclear medicine and molecular imaging (Eur J Nucl Med Mol Imaging) Vol. 44 Issue 13 Pg. 2195-2202 (Dec 2017) ISSN: 1619-7089 [Electronic] Germany
• PMID: 28812136 (Publication Type: Journal Article)

Chemical References

• Yttrium Radioisotopes
• Yttrium-90

Topics

• Aged
• Carcinoma, Hepatocellular (surgery, therapy)
• Embolization, Therapeutic
• Female
• Humans
• Liver Neoplasms (surgery, therapy)
• Male
• Middle Aged
• Treatment Outcome
• Yttrium Radioisotopes (therapeutic use)