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- W2583744999 abstract "The purpose of this study was to identify baseline characteristics and long-term prognostic factors in non-transplant patients with unresectable hepatocellular carcinoma (HCC) who had atypically long survival after treatment with yttrium-90 radioembolization (Y90). These factors should help define patterns of extended survivorship after Y90. With IRB approval, a search of our prospectively acquired database (2003-2016) identified 77 non-surgical HCC patients treated with Y90 and deemed “Super Survivors” (defined as ≥3yrs survivorship after Y90). Baseline characteristics were summarized for this retrospective series with baseline imaging and follow-up at 1mo and every 3 mo thereafter per institutional protocol at a single center. Overall survival (OS) was calculated from the day of Y90 to death or last follow-up with Kaplan-Meier estimates. OS was compared with the log-rank test for Child-Pugh (CP) score, distribution of disease, presence of portal vein thrombus (PVT), and technique (segmental vs lobar) at the time of Y90. The baseline characteristics were: median age 69.5yrs (range: 46-86yrs); 68% male; 72% Caucasian/11% Asian/7% African American/7% Hispanic/3% Unknown; 60% solitary HCC; 79% unilobar disease; 10% PVT; 8% ascites; Barcelona Clinic Liver Cancer stage A-56%/B-29%/C-14%/D-1%; CP A-68%/B-31%/C-1%. At the time of Y90, 70% were ≥65yrs. Longest baseline tumor diameter was 5.3 ± 3.8cm (mean ± SD). Median OS was 70mo (95% confidence interval; 65-88 mo). CP score stratified median OS at 88, 80, 70, 47, and 39 mo for CP scores of 5, 6, 7, 8, and 9, respectively (p = 0.0017). Unilobar vs bilobar disease, solitary vs multifocal, and presence of PVT did not stratify OS (p = 0.3796, p = 0.3821, p = 0.1399, respectively). Segmental vs lobar radioembolization was associated with improved OS with a median OS of 82 vs 56 mo, respectively (p = 0.0030). Super survivors have heterogeneous baseline characteristics and advanced age at the time of treatment yet maintained durable OS after radioembolization that is stratified by the extent of underlying liver disease. The implemented technical approach (segmental vs lobar) may be a relevant long-term predictor of OS in super survivors." @default.
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- W2583744999 date "2017-02-01" @default.
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- W2583744999 title "Radioembolization super survivors: hepatocellular carcinoma" @default.
- W2583744999 doi "https://doi.org/10.1016/j.jvir.2016.12.771" @default.
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