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• W3007990605 abstract "Hepatocellular carcinoma (HCC) patients presenting with elevated bilirubin levels are considered high-risk for liver-directed therapy. In this study we assessed short- and long-term outcomes of patients with HCC within Milan criteria who presented with baseline hyperbilirubinemia. With IRB approval, we retrospectively studied (2006-2017) HCC patients within Milan transplant criteria and baseline total bilirubin >2 mg/dL who had selective Y90. Bilirubin/Albumin toxicity analyses were conducted according to CTCAE v5.0 criteria (grade 2 moderate/grade 3 severe) at 1, 3 and 6-months post-Y90. Overall survival (OS), censored to liver transplant (LT) and intention-to-treat (ITT), was estimated using Kaplan-Meier method. 81 patients (65% males with average age 62 years (range, 35-83)), met inclusion criteria: 1 (1%) was Child-Pugh (CP) A, 59 (73%) CP B, and 21 (26%) CP C. 61 (75%) had solitary tumors. Median baseline bilirubin was 2.7 (2.1 – 8.1) mg/dL and albumin was 2.6 (1.5-3.6) g/dL. At 1-month post Y90: grade 2 and 3 bilirubin toxicity rates were 10% and 2.5% respectively. Grade 2 and 3 new albumin toxicities were 5% and 2.5%. At 3-months post Y90, 20% had grade 2, and 1.5% had grade 3 bilirubin toxicity. Only 8% showed new grade 2 albumin toxicity while none had grade 3. At 6-month, 20% and 9% had grade 2 and 3 bilirubin toxicities, and 7% and 2% had new albumin grade 2 and 3 toxicities (Table). No grade 4 toxicities occurred within 6-months of Y90. 3-Month mortality rate was 2.5%. 47 (58%) patients underwent LT at median time to LT of 6.3 (0.5-34) months post Y90. Median OS censored to LT was 27.8 (CI: 21-38) months. Median ITT OS was not reached at 110 months, with 3-and 5-year survival rates 70% and 59% respectively. Selective Y90 has an acceptable safety profile in HCC patients with baseline hyperbilirubinemia. In these patients, selective Y90 can successfully bridge to LT with excellent survival outcomes.Tabled 1TimeBilirubin ToxicityAlbumin ToxicityGrade 2Grade 3Grade 4Grade 2Grade 3Grade 41 month (n = 76)8 (10%)2 (2.5%)0 (0%)4 (5%)2 (2.5%)0 (0%)3 months (n = 60)12 (20%)1 (1.5%)0 (0%)5 (8%)0 (0%)0 (0%)6 months (n = 45)9 (20%)4 (9%)0 (0%)3 (7%)1 (2%)0 (0%) Open table in a new tab" @default.
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• W3007990605 date "2020-03-01" @default.
• W3007990605 modified "2023-10-16" @default.
• W3007990605 title "4:03 PM Abstract No. 144 Toxicity and survival outcomes of segmental radioembolization in hepatocellular carcinoma patients with baseline hyperbilirubinemia" @default.
• W3007990605 doi "https://doi.org/10.1016/j.jvir.2019.12.177" @default.
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