Abstract No. 145 Safety and Efficacy of Y-90 Embolization in Hepatocellular Carcinoma Patients Who Have Undergone Prior Resection: Analysis of the RESiN Registry (NCT02685631).

To compare whether HCC patients with previous resection have shorter survival or greater toxicity incidence when treated with Y90 resin microspheres. In this prospective, observational study, 214 HCC patients were separated based on prior hepatic surgery (PS, N = 20) or surgically naive (SN, N = 194). Inclusion criteria were BCLC A, B, or C with segmental or lobar portal vein thrombus. Previous surgeries included trisegmentectomy (n = 1), lobectomy (n = 10), or segmentectomy (n = 9). No patients had extrahepatic disease. Median patient age, gender, and the rate of ECOG score of 0, CP class A, BCLC class A or B and previous embolization were all similar (Table 145.1, p >0.05). SN patients had a higher BMI and greater incidence of tumor burden >10%. Treatment location and administered activity were tracked. OS was tracked from the day of treatment or until loss to follow-up (LTFU). OS between groups was compared using Kaplan–Meier analysis. Liver function toxicities within 3 months were assessed using the Common Terminology Criteria for Adverse Events (CTCAE) v5 with differences calculated via the Pearson Test. Whole liver treatments were more common in the SN (34/194, 18%) vs the PS (1/20, 5%) group (p< 0.001). Segmental treatment was used in 3/20 PS (15%) and 26/194 (13%) SN patients. Lobar treatment was used in 16/20 PS (80%) and 133/194 (69%) SN patients. Median administered activity was 1.2 GBq for each group (p=1). Overall survival was not significantly different (p = 0.7) for the resection group (35.4 months, 21-NR) compared to the surgically naïve group (30.9 months, 15.6-NR, p=0.7). There were no grade 5 toxicities. Three-month Grade 3 albumin toxicities developed in 0 (0%) PS and 1 (1%) SN patient (p=0.5). Grade 3 or 4 bilirubin toxicities developed within 3 months in 0 (0%) SN patients and 6 (3%) PS patients (0.8). HCC patients with prior hepatic surgery do not have shorter overall survival or greater incidence of toxicity when treated with Y90 radioembolization at the time of recurrence. Y90 radioembolization is an appropriate treatment for patients who do not qualify for additional hepatic surgery but require further intervention for hepatic disease.