Yttrium-90 Radioembolization for BCLC Stage C Hepatocellular Carcinoma Comparing Child–Pugh A Versus B7 Patients: Are the Outcomes Equivalent?

Objective To evaluate yttrium-90 (Y90) radioembolization outcomes across Child–Pugh scores in patients with advanced hepatocellular carcinoma (HCC). Materials and Methods From April 2005 to December 2018, 106 consecutive patients with BCLC Stage C HCC who underwent Y90 radioembolization were retrospectively analyzed. Exclusion criteria included additional malignancy ( n = 7), death unrelated to liver disease ( n = 2), metastases ( n = 2), or lack of follow-up data ( n = 4). Ninety-one patients were analyzed. Overall survival (OS) was calculated using the Kaplan–Meier method and compared between groups with the log-rank test. Cox regression modeling was used to evaluate the prognostic factors for survival. Results Mean age was 63 years and 85.7% were male. HCV infection was the most common etiology of liver disease (58.2%). Sixty-four (70.3%) patients were Child–Pugh A, 19 (20.9%) patients were B7, and eight (8.8%) patients were B8–9. Median OS after radioembolization was 20.2 [95% confidence interval (CI) 13.0–27.4], 6.0 (95% CI 4.4–7.6), and 5.5 (95% CI 2.5–8.5) months for Child–Pugh A, B7, and B8/9 groups, respectively ( P