Early institutional experience in 100 patients with hepatocellular carcinoma treated with glass microspheres yttrium-90 embolization

This submission has open access
Submission ID :
GEST2021-129
Submission Type
Submission Topic
Sub-topics
IO
Purpose :
To identify evolving trends and outcomes in a recently instituted Y-90 radioembolization program for hepatocellular carcinoma at a single academic institution.
Materials & Methods :
A prospectively maintained database of glass microspheres Y-90 administrations at our institution from April 2014 to May 2020 was reviewed for the first 100 consecutive patients treated for hepatocellular carcinoma (HCC). Chart review was performed to fill in and update data.
Results :
100 patients (81M:19F) with cirrhosis from HCV (47), ALD (11), combined HCV/ALD (7), NAFLD (9), unknown (19) or other etiologies (7) had an average age of 67.6 years. 21 patients were within Milan or San Francisco criteria. Administrations were lobar (+/- segmental) in 55 and segmental only in 45. Adjunctive locoregional and/or XRT treatments were performed in 28 patients pre- and 15 patients post Y-90, with 11 patients receiving treatments both pre- and post Y-90. Pre-procedural ALBI scores were 1 (29), 2 (66), and 3 (5). 16 patients experienced a decline in their ALBI score of at least one point within 1-2 month follow up. 1 patient had an access site pseudoaneurysm treated with thrombin injection, and 2 patients suffered post procedural rupture of a treated HCC.
13 patients were transplanted; the first 4 received lobar Y-90 and the subsequent 9 received segmentectomy. Of the 13 patients, 4 had received locoregional therapies prior to Y-90, 5 received standalone single segmentectomy Y-90 treatment, and 6 patients required subsequent secondary locoregional therapies. 7 patients were down-staged and 6 maintained within Milan criteria until transplant; of these, 8 had > 50% tumoral necrosis demonstrated on pathology.
18 patients were lost to follow up within 6 months of Y-90 treatment; these and 9 patients with surgical resections prior to Y-90 were excluded from overall survival (OS) data. OS of the remaining patients from diagnosis of HCC to death (29) was 24.7 mo and for those to last known clinical follow-up (30) was 20.4 mo.
Conclusions :
Y-90 radioembolization is a useful therapy for management of patients with hepatocellular carcinoma, with a significant percentage of our patients making it to transplant or actively waiting on the transplant list at the time of this report.159 More than half of patients required adjunctive other locoregional therapies or SBRT. OS from time of diagnosis was 24.7 mo in those with complete records and at least 20.4 mo in those with incomplete medical records at time of most recent clinical follow up.
Poster Abstract :
If the file does not load, click here to open/download the file.

Associated Sessions

Chief, IR
,
Loma Linda University Health
Loma Linda University Health
Loma Linda University Health
Loma Linda University Health
Loma Linda University Health

Similar Abstracts by Type

Submission ID
Submission Title
Submission Topic
Submission Type
Primary Author
GEST2021-69
Renal
Poster Abstract
Priyam Choudhury
GEST2021-103
Gastrointestinal (GI)
Poster Abstract
Dr. Diego Meo
GEST2021-121
Peripheral Arterial/Aortic
Poster Abstract
Dr. Abtin Jafroodifar
GEST2021-54
Men's Health
Poster Abstract
Dr. Ryan Thibodeau
GEST2021-80
Vascular Malformations
Poster Abstract
Mrs. Dian Dewi
GEST2021-120
Gastrointestinal (GI)
Poster Abstract
Dr. Abtin Jafroodifar
GEST2021-127
Visceral Aneurysms/Pseudoaneurysms
Poster Abstract
Dr. JAGADEESAN DHANASEKARAN
52 hits