Abstract No. 262 90Y Radioembolization for Hepatocellular Carcinoma with Portal Vein Thrombosis: Prognostic Factors in 115 Patients

To investigate the prognostic factor in 90Y radioembolization for hepatocellular carcinoma (HCC) with portal vein invasion. Between Jan 2016 and Dec 2021, 115 treatment-naïve HCC patients with portal vein thrombosis underwent 90Y 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-Meier method and long-rank test, and prognostic factors was evaluated by Cox proportional hazard model with SPSS 25. 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 >150 Gy) had longer survival (median, 19 months) than patients with regular dose (<150 Gy) (7.8 months. Patients with unilobar disease (median, 35.6 months) had longer survival than those with bi-lobar disease (median, 6.0 months). Multivariate analysis revealed that unilobar disease, and segmental PVT were significant prognostic factors. (P< 0.05). Radioembolization should be considered as a priority over systemic chemotherapy in HCC patients with segmental PVT and unilobar disease.