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SIR 2025

Interventional Oncology

Traditional Poster

Session: Traditional Poster Presentations

68 - Toxicity and Survival Outcomes of Yttrium-90 Radioembolization Treatment in Patients with Metabolic Dysfunction-Associated Steatohepatitis-Derived Hepatocellular Carcinoma

Monday, March 31, 2025
12:10 PM – 1:10 PM CT
Location: Music City Center, Expo Poster Area
Purpose: The global prevalence of metabolic dysfunction-associated steatohepatitis (MASH) is increasing, leading to a subsequent rise in MASH-derived hepatocellular carcinoma (HCC). This study explores the toxicity and survival outcomes of yttrium-90 (Y-90) trans-arterial radioembolization (TARE) treatment in patients with MASH-associated HCC.

Materials and Methods: This IRB-approved single-institution study retrospectively analyzed patients with MASH as the primary risk factor for cirrhosis, who were treated for HCC with TARE between December 2003 and December 2018. Toxicities were graded according to Common Terminology Criteria for Adverse Events, version 5.0 (CTCAE V5). Median overall survival (OS) was reported from the date of TARE to death or censored to date of last follow-up. Univariate and multivariate analyses were conducted using log-rank test and Cox proportional hazards respectively to evaluate predictors of OS. 

Results: 108 patients (61 males/47 females) undergoing a total of 110 TARE procedures met the inclusion criteria. Posttreatment grade 3/4 toxicities included bilirubin (5.5%), alanine transaminase (0.9%), aspartate transaminase (2.8%), and lymphopenia (1.9%). Fatigue was the only 1 (0.9%) post-treatment grade 3/4 clinical toxicity. Median censored overall survival (OS) was 29.2 months (95% CI,19.2–37.2) for the total cohort. When stratified, median censored OS was 51.5 months (95% CI, 24.7–127.9), 32.4 months (95% CI, 6.4–62.8), 19.3 months (95% CI, 10.2-34.8), and 6.0 months (95% CI,1.17–78.5) for Barcelona Clinic Liver Cancer (BCLC) A, B, C, and D, respectively, and 31.6 (95% CI, 22.5–51.5), 28.4 (95% CI, 9.7–37.5), and 6 (95% CI, NE). Univariate analysis revealed extrahepatic metastasis, tumor size greater than 5cm, and portal vein thrombus as predictors of OS. Extrahepatic metastasis and PVT remained significant predictors of survival after multivariate analysis.

Conclusion: Y-90 radioembolization is safe and effective in patients with MASH-derived hepatocellular carcinoma. These findings suggest that TARE is a viable treatment option for this patient population, which may guide management as the prevalence of MASH-associated cirrhosis and HCC increases worldwide.