What determines survival duration in hepatocellular carcinoma treated with intraarterial Yttrium-90 microspheres?

Abstract

Background/aims: The survival duration of patients with nonresectable hepatocellular carcinoma confined to the liver and treated with intraarterial yttrium-90 microspheres was highly variable.

Methodology: Eighty-two patients treated by this method were analyzed. Thirty-one patients who lived for one year or longer from the date of first treatment were classified as 'long survivors' and 51 patients who died within 1 year were classified as 'short survivors'.

Results: Comparison between the 2 categories suggested that lower pretreatment level of alpha-fetoprotein and higher tumor-to-normal uptake ratio of yttrium-90 microspheres favored longer survival. Results also indicated that the treatment was effective even for large tumors and for postoperative recurrence. Repeated treatment of viable residual or recurrent tumors offered further palliation and prolongation of survival.

Conclusions: Pretreatment alpha-fetoprotein level, tumor-to-normal uptake ratio of yttrium-90 microspheres and the number of treatments determine survival duration.