Gastrointestinal Cancer

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SU_15_2147 - Preliminary findings on overall survival from a recent single-center cohort of patients treated with yttrium-90 resin microspheres for unresectable HCC

Sunday, October 21
1:15 PM - 2:45 PM
Location: Innovation Hub, Exhibit Hall 3

Preliminary findings on overall survival from a recent single-center cohort of patients treated with yttrium-90 resin microspheres for unresectable HCC
R. M. Shah, S. Sheikh, J. Shah, A. Mejia, I. Shahin, and P. S. Mantry; The Liver Institute and Interventional Radiology, Methodist Dallas Medical Center, Dallas, TX

Purpose/Objective(s): Median overall survival (OS) after selective internal radiation therapy with Y-90 resin microspheres (Y-90 SIRT) for unresectable hepatocellular carcinoma (HCC) has ranged from 4 to 41 months in prospective and retrospective studies. In a previous study of patients treated at our center from 2004 to 2013, OS was 13.1 months (Mantry et al. 2017). We are retrospectively examining a more recent cohort of patients to determine whether outcomes have improved from those we reported earlier and to further examine factors that predict response.

Materials/Methods: Demographics, disease etiology and presentation, Y-90 treatment parameters, response, and OS were abstracted from the charts of patients with unresectable HCC treated with Y-90 SIRT at our facility from April 2013 through March 2017 (n = 150). OS (from the first Y-90 SIRT treatment to death or last follow-up) was assessed with the Kaplan-Meier method.

Results: To date, we have analyzed data from 63 patients with HCC who underwent 89 SIRT procedures. Most were male (78%) and white (71%). Hepatitis C was the most common etiology (49%). Mean MELD score was 6.6 (SD 4.9). Most patients (41/63, 65%) had a single Y-90 SIRT treatment, 19 (30%) had 2 treatments, and 3 (5%) had >2 treatments. Best RECIST response was available for 45 patients and was complete response in 10 (22%), partial in 16 (36%), stable disease in 12 (27%), and progression in 7 (16%). Median OS was 19.3 months (95% CI 12.4, 26.1). The presence of ascites was associated with shorter OS (9.6 vs. 26.1 months, P < .001), and white race was associated with shorter OS (16.3 months) than nonwhite race (median not reached, P = .007). Median OS was also not reached for patients (n = 6) with subsequent liver transplant.

Conclusion: Survival in this analyzed subset of patients (19.3 months) was longer than in our previously reported cohort (13.1 months), possibly due to improved technique (especially the use of single-lobe and segmental SIRT) and patient selection over time. Future analyses will investigate OS in the full cohort and compare factors predicting survival between our current and previous cohorts and in the 2 cohorts combined.

Author Disclosure: R.M. Shah: Employee; Vista Cancer Center. S. Sheikh: None. J. Shah: None. A. Mejia: None. P.S. Mantry: None.

Rucha Shah, MD

Biography:
Dr. Rucha Shah is completing her Gastroenterology fellowship at Methodist Dallas Medical Center, in Dallas, Texas. She is going to be presenting information on using Y-90 therapy for unresectable hepatocellular carcinoma and the improvement in overall survival with this treatment modality. She is originally from Chicago, and enjoys traveling during her spare time.

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