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Treatment of hepatic tumors with Yittrium-90 (Y-90) radioembolization is a currently utilized therapy for this invasive and often fatal malignancy. Two recently published studies utilizing high-dose super selective Y-90 radioembolization for curative treatment have shown excellent results. However, information regarding the effectiveness of selective Y-90 treatment and long-term outcomes specific to the segment of treatment is not robust. This study aims to evaluate our institution's experience and the long-term mortality outcomes among patients with primary hepatocellular carcinoma (HCC) treated with super selective Y-90 by comparing treatment locations. A total of 524 patient Y-90 cases from 2012 to 2023 were reviewed, and 135 patients were treated with super selective Y-90 for primary HCC. 1-year and 5-year follow-up data and all-cause patient mortality data were recorded. Any patient who was not treated with super selective Y-90 (lobar treatments) for treatment of primary HCC was excluded. Of these patients, 75 received single lobe super selective Y-90 and their all-cause mortality rates were compared. 135 patients were included in the analysis. 71 patients followed up at 1 year, 10 at 5 years, and 32 died based on chart records. 75 patients underwent super selective single lobe only Y-90 and of those all-cause mortality was 24%. Table 546.1 represents mortality outcomes in relation to the liver segment treated. There was no statistically significant difference between groups with p=0.7. This data, although with limitations due to the number of patients, suggests there is no significant difference in patient mortality depending on the liver segment treated with super selective Y-90 in patients with primary HCC. Further studies with larger patient populations as well as further consideration for confounding factors should be conducted before conclusions can be made.
Tomaszek et al. (Wed,) studied this question.