Viral hepatitis associated hepatocellular carcinoma outcomes with yttrium-90 radioembolization.

Background: Viral associated (VA) malignancies have recently been correlated with improved outcomes. We sought to evaluate outcomes of patients with hepatocellular carcinoma (HCC) with and without viral hepatitis (hepatitis B and C) treated with lobar yttrium-90 radioembolization (Y-90 RE). Methods: After IRB approval, an institutional database of patients with HCC who received RE between 2009–2014 was queried and 99 patients were identified that received a total of 122 lobar RE. Charts were reviewed to capture previous treatments, viral hepatitis status, α-fetoprotein values (AFP), Child-Pugh class (CP), albumin-bilirubin score (ALBI), portal vein thrombosis (PVT), volumes treated and doses delivered. Comparison was made with Chi-square and Mann-Whitney U test. Intrahepatic control (IHC), extrahepatic control (EHC), progression free survival (PFS), and overall survival (OS) were calculated according to the Kaplan-Meier method stratified by cause of underlying liver disease (viral vs . non-viral) and survival differences were assessed via the log-rank test. Hazard ratios were calculated using Cox regression. Results: Median follow up for VA HCC and non-VA (NVA) HCC patients was 10.9 months (range, 0.8–46.7 months) and 11.8 months (range, 1.1–62.8 months), respectively. Patients with VA HCC (n=44) were younger (P Conclusions: Patients with VA HCC had a trend to improved IHC and significantly worse EHC. Prospective investigation of novel systemic therapies following Y-90 RE in patients with VA HCC is warranted to potentially further extend survival in VA HCC patients by addressing extra-hepatic disease.