Clinical outcomes of Y90 radioembolization for recurrent hepatocellular carcinoma following curative resection

Rehan Ali, Ahsun Riaz, Ahmed Gabr, Nadine Abouchaleh, Ronald Mora, Ali Al Asadi, Juan C Caicedo, Michael Messod Abecassis, Nitin N Katariya, Haripriya Maddur, Laura M Kulik, Robert J Lewandowski, Riad Salem*

*Corresponding author for this work

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose To assess safety/efficacy of yttrium-90 radioembolization (Y90) in patients with recurrent hepatocellular carcinoma (HCC) following curative surgical resection. Methods With IRB approval, we searched our prospectively acquired database for patients that were treated with Y90 for recurrent disease following resection. Baseline characteristics and bilirubin toxicities following Y90 were evaluated. Intention-to-treat overall survival (OS) and time-toprogression (TTP) from Y90 were assessed. Results Forty-one patients met study inclusion criteria. Twenty-six (63%) patients had undergone minor (≤3 hepatic segments) resection while 15 (37%) patients underwent major (>3 hepatic segments) resections. Two patients (5%) had biliary-enteric anastomoses created during surgical resection. The median time from HCC resection to the first radioembolization was 17 months (95% CI: 13-37). The median number of Y90 treatment sessions was 1 (range: 1-5). Ten patients received (entire remnant) lobar Y90 treatment while 31 patients received selective (≤2 hepatic segments) treatment. Grades 1/2/3/4 bilirubin toxicity were seen in nine (22%), four (10%), four (10%), and zero (0%) patients following Y90. No differences in bilirubin toxicities were identified when comparing lobar with selective approaches (P = 0.20). No post-Y90 infectious complications were identified. Median TTP and OS were 11.3 (CI: 6.5-15.5) and 22.1 months (CI: 10.3-31.3), respectively. Conclusions Radioembolization is a safe and effective method for treating recurrent HCC following surgical resection, with prolonged TTP and promising survival outcomes.

Original languageEnglish (US)
Pages (from-to)2195-2202
Number of pages8
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume44
Issue number13
DOIs
StatePublished - Jan 1 2017

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Yttrium
Hepatocellular Carcinoma
Bilirubin
Survival
Liver
Research Ethics Committees
Therapeutics
Databases
Safety

Keywords

  • Hepatic resection
  • Hepatocellular carcinoma
  • Y90 radioembolization

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{190dac8a946a4d56ba2703fe3c1c7604,
title = "Clinical outcomes of Y90 radioembolization for recurrent hepatocellular carcinoma following curative resection",
abstract = "Purpose To assess safety/efficacy of yttrium-90 radioembolization (Y90) in patients with recurrent hepatocellular carcinoma (HCC) following curative surgical resection. Methods With IRB approval, we searched our prospectively acquired database for patients that were treated with Y90 for recurrent disease following resection. Baseline characteristics and bilirubin toxicities following Y90 were evaluated. Intention-to-treat overall survival (OS) and time-toprogression (TTP) from Y90 were assessed. Results Forty-one patients met study inclusion criteria. Twenty-six (63{\%}) patients had undergone minor (≤3 hepatic segments) resection while 15 (37{\%}) patients underwent major (>3 hepatic segments) resections. Two patients (5{\%}) had biliary-enteric anastomoses created during surgical resection. The median time from HCC resection to the first radioembolization was 17 months (95{\%} CI: 13-37). The median number of Y90 treatment sessions was 1 (range: 1-5). Ten patients received (entire remnant) lobar Y90 treatment while 31 patients received selective (≤2 hepatic segments) treatment. Grades 1/2/3/4 bilirubin toxicity were seen in nine (22{\%}), four (10{\%}), four (10{\%}), and zero (0{\%}) patients following Y90. No differences in bilirubin toxicities were identified when comparing lobar with selective approaches (P = 0.20). No post-Y90 infectious complications were identified. Median TTP and OS were 11.3 (CI: 6.5-15.5) and 22.1 months (CI: 10.3-31.3), respectively. Conclusions Radioembolization is a safe and effective method for treating recurrent HCC following surgical resection, with prolonged TTP and promising survival outcomes.",
keywords = "Hepatic resection, Hepatocellular carcinoma, Y90 radioembolization",
author = "Rehan Ali and Ahsun Riaz and Ahmed Gabr and Nadine Abouchaleh and Ronald Mora and {Al Asadi}, Ali and Caicedo, {Juan C} and Abecassis, {Michael Messod} and Katariya, {Nitin N} and Haripriya Maddur and Kulik, {Laura M} and Lewandowski, {Robert J} and Riad Salem",
year = "2017",
month = "1",
day = "1",
doi = "10.1007/s00259-017-3792-3",
language = "English (US)",
volume = "44",
pages = "2195--2202",
journal = "European Journal Of Nuclear Medicine",
issn = "0340-6997",
publisher = "Springer Verlag",
number = "13",

}

TY - JOUR

T1 - Clinical outcomes of Y90 radioembolization for recurrent hepatocellular carcinoma following curative resection

AU - Ali, Rehan

AU - Riaz, Ahsun

AU - Gabr, Ahmed

AU - Abouchaleh, Nadine

AU - Mora, Ronald

AU - Al Asadi, Ali

AU - Caicedo, Juan C

AU - Abecassis, Michael Messod

AU - Katariya, Nitin N

AU - Maddur, Haripriya

AU - Kulik, Laura M

AU - Lewandowski, Robert J

AU - Salem, Riad

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Purpose To assess safety/efficacy of yttrium-90 radioembolization (Y90) in patients with recurrent hepatocellular carcinoma (HCC) following curative surgical resection. Methods With IRB approval, we searched our prospectively acquired database for patients that were treated with Y90 for recurrent disease following resection. Baseline characteristics and bilirubin toxicities following Y90 were evaluated. Intention-to-treat overall survival (OS) and time-toprogression (TTP) from Y90 were assessed. Results Forty-one patients met study inclusion criteria. Twenty-six (63%) patients had undergone minor (≤3 hepatic segments) resection while 15 (37%) patients underwent major (>3 hepatic segments) resections. Two patients (5%) had biliary-enteric anastomoses created during surgical resection. The median time from HCC resection to the first radioembolization was 17 months (95% CI: 13-37). The median number of Y90 treatment sessions was 1 (range: 1-5). Ten patients received (entire remnant) lobar Y90 treatment while 31 patients received selective (≤2 hepatic segments) treatment. Grades 1/2/3/4 bilirubin toxicity were seen in nine (22%), four (10%), four (10%), and zero (0%) patients following Y90. No differences in bilirubin toxicities were identified when comparing lobar with selective approaches (P = 0.20). No post-Y90 infectious complications were identified. Median TTP and OS were 11.3 (CI: 6.5-15.5) and 22.1 months (CI: 10.3-31.3), respectively. Conclusions Radioembolization is a safe and effective method for treating recurrent HCC following surgical resection, with prolonged TTP and promising survival outcomes.

AB - Purpose To assess safety/efficacy of yttrium-90 radioembolization (Y90) in patients with recurrent hepatocellular carcinoma (HCC) following curative surgical resection. Methods With IRB approval, we searched our prospectively acquired database for patients that were treated with Y90 for recurrent disease following resection. Baseline characteristics and bilirubin toxicities following Y90 were evaluated. Intention-to-treat overall survival (OS) and time-toprogression (TTP) from Y90 were assessed. Results Forty-one patients met study inclusion criteria. Twenty-six (63%) patients had undergone minor (≤3 hepatic segments) resection while 15 (37%) patients underwent major (>3 hepatic segments) resections. Two patients (5%) had biliary-enteric anastomoses created during surgical resection. The median time from HCC resection to the first radioembolization was 17 months (95% CI: 13-37). The median number of Y90 treatment sessions was 1 (range: 1-5). Ten patients received (entire remnant) lobar Y90 treatment while 31 patients received selective (≤2 hepatic segments) treatment. Grades 1/2/3/4 bilirubin toxicity were seen in nine (22%), four (10%), four (10%), and zero (0%) patients following Y90. No differences in bilirubin toxicities were identified when comparing lobar with selective approaches (P = 0.20). No post-Y90 infectious complications were identified. Median TTP and OS were 11.3 (CI: 6.5-15.5) and 22.1 months (CI: 10.3-31.3), respectively. Conclusions Radioembolization is a safe and effective method for treating recurrent HCC following surgical resection, with prolonged TTP and promising survival outcomes.

KW - Hepatic resection

KW - Hepatocellular carcinoma

KW - Y90 radioembolization

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U2 - 10.1007/s00259-017-3792-3

DO - 10.1007/s00259-017-3792-3

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JO - European Journal Of Nuclear Medicine

JF - European Journal Of Nuclear Medicine

SN - 0340-6997

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