Transcatheter-directed Y-90 radioembolization compared with chemoembolization for the treatment of hepatic metastases from colon cancer.

person Peter Young University of Texas Medical Branch at Galveston, Galveston, TX info_outline Peter Young, Brittany Miles, Brittany Dang, James David Mackey

Authors person Peter Young University of Texas Medical Branch at Galveston, Galveston, TX info_outline Peter Young, Brittany Miles, Brittany Dang, James David Mackey Organizations University of Texas Medical Branch at Galveston, Galveston, TX, Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, League City, TX, Alara Medical Group, Dallas, TX Abstract Disclosures Research Funding No funding received None. Background: Arterially directed embolic therapy has been a mainstay in the management of hepatic malignancy of both primary and metastatic origin. The benefits of transcatheter-directed Yttrium-90 radioembolization (TARE) and chemoembolization (TACE) in conjunction with systemic therapy are well documented, though only TARE is currently recommended for the management of hepatic metastases from colon cancer. We evaluated patients who underwent TARE or TACE to assess survival rates at 2 years post-procedure. Methods: The TriNetX Diamond network was used for this study. TriNetX provides access to anonymized medical record information on more than 213 million patients in 92 large healthcare organizations. Two cohorts of patients were created utilizing International Classification of Disease-10 (ICD-10) codes. All patients were required to have colon cancer (C18), liver metastases (C78.7), and liver-directed treatment (CPT code 37243). One cohort received chemoembolization (CPT 96420) while the other received Yttrium-90 microspheres (CPT 79445). The cohorts were balanced for age, race, gender, and ethnicity, resulting in 336 patients in each arm. They were then evaluated for risk of death at two years. Results: Patients who received Y-90 had a risk ratio for death of 1.23 compared to patients treated with chemoembolization. Figure 1. Conclusions: Patients who underwent TARE were at a significantly higher risk of mortality at 2 years post-procedure compared to those who underwent TACE. As only Y-90 radioembolization is currently recommended under NCCN guidelines for the treatment of hepatic metastatic lesions from colon cancer, we hope to further discussion among specialists to determine whether TACE may provide an alternative treatment option. Risk of death at two years. Cohort Cohort Size Number of Deaths 24-Month Risk of Death Y-90 336 174 51.79% ChemoEmbolization 336 141 41.96% Risk ratio 1.23, 95% CI (1.05,1.45), p-value 0.01.