A Retrospective Comparative Analysis of the Effect of Y90-radioembolization on the Survival of Patients with Unresectable Hepatocellular Carcinoma

Backgroung/Aims: to determine the impact of Y90-Radioembolization on survival when used as a first-line treatment for unresectable HCC. Methodology: We retrospectively analyzed 35 consecutive patients with unresectable HCC who received 90Y-labeled resin microspheres as first-line treatment and compared their overall survival from the time of diagnosis with that of a cohort of 43 patients with unresectable HCC that were potential candidates for Y90-Radioembolization but had received conventional care due to unavailability or technical contraindications. Patients in both groups had a similar liver function and tumor burden. Results: Median survival from diagnosis was significantly higher in the radioembolization group compared with controls (16 vs. 8 months; p< 0.05), even after adjusting for cirrhosis, multinodular disease, bilobar involvement or vascular invasion. In a multivariate analysis, treatment by radioembolization was the only prognostic factor independently associated with improved survival. In an intention-to-treat analysis, patients evaluated for radioembolization (finally treated or not) survived longer than controls (13 vs. 10 months; p< 0.05). Conclusion: Y90-Radioembolization is likely to improve survival among patients with unresectable HCC compared with conventional treatment. Further prospective studies are needed to evaluate the potential of this new treatment modality in unresectable HCC.