Y-90 radioembolization for Hepatocellular carcinoma with portal vein thrombosis : prognostic factors in 115 patients

Wednesday, March 8, 2023

3:09 PM – 3:18 PM

Location: Phoenix Convention Center, 224AB

Presenting Author(s)

Gyoung Min Kim, MD

Assistant Professor
Yonsei University Severance Hospital

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

Hyo-Cheol Kim, MD

Clinical professor
Seoul National University Hospital
ML

Myungsu Lee, n/a

assistant professor
seoul national university hospital
MK

Minyoung Kim, n/a

assistant professor
Kangdong Kyoung Hee university hospital
YJ

Yoon Soo Jeong, n/a

assistant professor
seoul national university hospital

Disclosure(s):

Gyoung Min Kim, MD: No financial relationships to disclose

Hyo-Cheol Kim, MD: No financial relationships to disclose

Purpose: To investigate the prognostic factor in Y-90 radioembolization for hepatocellular carcinoma (HCC) with portal vein invasion

Materials and Methods: Between Jan 2016 and Dec 2021, 115 treatment-naïve HCC patients with portal vein thrombosis underwent Y-90 radioembolization in author’s institute. Medical records and radiologic images were retrospectively reviewed with focus on prognostic factors and long-term outcome. Survival analysis was evaluated by the Kaplan-Meider method and long-rank test, and prognostic factors was evaluated by Cox proportional hazard model with SPSS 25.

Results: 115 HCC patients with portal vein thrombosis were treated by glass microspheres. 110 patients belonged to Child-Pugh A, and PVT level was main PV (n = 22), lobar PV (n = 55), and segmental PV (n = 38), respectively. Median overall survival was 16.8 months. Patients with segmental PVT (median 27.2 months) had longer survival than those with lobar PVT (median 19.0 months) and main PVT (5.5 months). Patients with boosted dose (mean absorbed dose >150Gy) had longer survival (median 19 months) than patients with regular dose ( < 150Gy) (7.8 months. Patients with uni-lobar disease (median 35.6 months) had longer survival than those with bi-lobar disease (median 6.0 months). Multivariate analysis revealed that uni-lobar disease, and segmental PVT were significant prognostic factors. (p < 0.05).

Conclusion: Radioembolization should be considered as a priority over systemic chemotherapy in HCC patients with segmental PVT and uni-lobar disease.