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

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

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-to-progression (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.

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Authors and Affiliations

  1. Department of Radiology, Section of Interventional Radiology, Northwestern University, 676 N. St. Clair, Suite 800, Chicago, IL, 60611, USA

    Rehan Ali, Ahsun Riaz, Ahmed Gabr, Nadine Abouchaleh, Ronald Mora, Ali Al Asadi, Robert J. Lewandowski & Riad Salem

  2. Department of Surgery, Division of Transplant Surgery, Northwestern University, Chicago, IL, USA

    Juan Carlos Caicedo, Michael Abecassis, Nitin Katariya & Riad Salem

  3. Department of Medicine, Division of Hepatology, Northwestern University, Chicago, IL, USA

    Haripriya Maddur & Laura Kulik

  4. Department of Medicine, Division of Hematology and Oncology, Northwestern University, Chicago, IL, USA

    Robert J. Lewandowski & Riad Salem

Authors
  1. Rehan Ali
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  2. Ahsun Riaz
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  3. Ahmed Gabr
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  4. Nadine Abouchaleh
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  6. Ali Al Asadi
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  7. Juan Carlos Caicedo
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  8. Michael Abecassis
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  9. Nitin Katariya
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  11. Laura Kulik
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  12. Robert J. Lewandowski
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  13. Riad Salem
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Contributions

Study concept and design: Rehan Ali, Ahsun Riaz, Ahmed Gabr, Nadine Abouchaleh, Riad Salem and Robert J Lewandowski.

Acquisition of data: Rehan Ali, Ahsun Riaz, Ahmed Gabr, Nadine Abouchaleh, Ronald Mora, Ali Alasadi, Riad Salem and Robert J Lewandowski.

Analysis and interpretation of data: Rehan Ali, Ahsun Riaz, Ahmed Gabr, Nadine Abouchaleh, Ronald Mora, Ali Alasadi, Riad Salem and Robert J Lewandowski.

Drafting of the manuscript: Rehan Ali, Ahsun Riaz, Ahmed Gabr, Nadine Abouchaleh, Ronald Mora, Ali Alasadi, Riad Salem and Robert J Lewandowski.

Critical revision of the manuscript for important intellectual content: Rehan Ali, Ahsun Riaz, Ahmed Gabr, Nadine Abouchaleh, Ronald Mora, Ali Alasadi, Juan Carlos Caicedo, Michael Abecassis, Nitin Katariya, Haripriya Maddur, Laura Kulik, Robert J. Lewandowski, Riad Salem.

Statistical analysis: Rehan Ali, Ahmed Gabr, Nadine Abouchaleh, Ahsun Riaz, Robert J Lewandowski, Riad Salem.

Administrative, technical, or material support: Rehan Ali, Ahsun Riaz, Ahmed Gabr, Nadine Abouchaleh, Ronald Mora, Ali Alasadi, Riad Salem and Robert J Lewandowski.

Study supervision: Rehan Ali, Ahsun Riaz, Ahmed Gabr, Nadine Abouchaleh, Riad Salem and Robert J Lewandowski.

Corresponding author

Correspondence to Riad Salem.

Ethics declarations

Disclosure of potential conflicts of interest

Laura Kulik, Robert Lewandowski and Riad Salem are advisors to BTG International. No other conflicts exist.

Ethical approval

This study was compliant with the Health Insurance Portability and Accountability Act and approved by the Northwestern University Institutional Review Board.

Informed consent

For this type of study, formal consent is not required.

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Ali, R., Riaz, A., Gabr, A. et al. Clinical outcomes of Y90 radioembolization for recurrent hepatocellular carcinoma following curative resection. Eur J Nucl Med Mol Imaging 44, 2195–2202 (2017). https://doi.org/10.1007/s00259-017-3792-3

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  • DOI: https://doi.org/10.1007/s00259-017-3792-3

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