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SIR 2026

Scientific Session

Interventional Oncology

Session: Radioembolization 1

79 - The Prognostic Value of Baseline Hemoglobin in Hepatocellular Carcinoma Treated with Yttrium-90 Radioembolization: An Institutional Experience from 705 Patients

Sunday, April 12, 2026
4:12 PM - 4:21 PM ET
Purpose: To evaluate the prognostic value of baseline hemoglobin (Hgb) levels in patients with hepatocellular carcinoma (HCC) undergoing Yttrium-90 (Y90) transarterial radioembolization (TARE). The hypothesis was that lower Hgb predicts worse overall survival (OS).

Materials and Methods: This retrospective IRB-approved study included 705 HCC patients treated with Y90 TARE using glass microspheres [Boston Scientific, MA, USA] from 2004 to 2019. Baseline Hgb was recorded on the day of treatment, and patients were stratified into three groups: ≥13.0, 10.0–12.9, and < 10.0 g/dL. Demographics, liver function, tumor burden, and etiology were recorded. OS was estimated using Kaplan-Meier analysis and compared by log-rank test. Multivariate Cox proportional hazards regression was used to identify independent predictors of OS with hazard ratios (HR).

Results: The mean baseline Hgb was 11.67 ± 1.93 g/dL. Lower Hgb was significantly associated with older age, female sex, larger tumor size, and worse liver function. Median OS was 58.9 months for ≥13.0 g/dL, 22.4 months for 10.0–12.9 g/dL, and 13.8 months for < 10.0 g/dL (log-rank p< 0.0001). On multivariate analysis, baseline Hgb remained an independent predictor of OS. Compared to patients with Hgb ≥13.0 g/dL, those with levels of 10.0–12.9 g/dL and < 10.0 g/dL had a HR 1.28 (95% CI, 1.01–1.62; p=0.038) and 2.04 (95% CI, 1.55–2.70; p< 0.001), respectively. Other independent predictors of worse OS included older age (HR 1.02; p=0.001), PVT (HR 2.54; p< 0.001), multifocal disease (HR 1.65; p< 0.001), extrahepatic metastasis (HR 2.01; p< 0.001), and tumor size large than >5 cm (HR 2.37, p< 0.001). Gender was not independently associated with survival.

Conclusion: Baseline Hgb independently predicts OS in patients with HCC treated with Y90 TARE after treatment with glass microspheres. Lower Hgb levels correlated with significantly reduced OS. Future research should assess whether correcting anemia improves clinical outcomes.