Predictors of Survival after Yttrium-90 Radioembolization for Colorectal Cancer Liver Metastases

Ashley A. Weiner, Bin Gui, Neil B. Newman, John L. Nosher, Fady Yousseff, Shou En Lu, Gretchen M. Foltz, Darren Carpizo, Jonathan Lowenthal, Darryl A. Zuckerman, Ben Benson, Jeffrey R. Olsen, Salma K. Jabbour, Parag J. Parikh

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Purpose: To identify clinical parameters that are prognostic for improved overall survival (OS) after yttrium-90 radioembolization (RE) in patients with liver metastases from colorectal cancer (CRC). Materials and Methods: A total of 131 patients who underwent RE for liver metastases from CRC, treated at 2 academic centers, were reviewed. Twenty-one baseline pretreatment clinical factors were analyzed in relation to OS by the Kaplan-Meier method along with log-rank tests and univariate and multivariate Cox regression analyses. Results: The median OS from first RE procedure was 10.7 months (95% confidence interval [CI], 9.4–12.7 months). Several pretreatment factors, including lower carcinoembryonic antigen (CEA; ≤20 ng/mL), lower aspartate transaminase (AST; ≤40 IU/L), neutrophil-lymphocyte ratio (NLR) <5, and absence of extrahepatic disease at baseline were associated with significantly improved OS after RE, compared with high CEA (>20 ng/mL), high AST (>40 IU/L), NLR ≥5, and extrahepatic metastases (P values of <.001, <.001,.0001, and.04, respectively). On multivariate analysis, higher CEA, higher AST, NLR ≥5, extrahepatic disease, and larger volume of liver metastases remained independently associated with risk of death (hazard ratios of 1.63, 2.06, 2.22, 1.48, and 1.02, respectively). Conclusions: The prognosis of patients with metastases from CRC is impacted by a complex set of clinical parameters. This analysis of pretreatment factors identified lower AST, lower CEA, lower NLR, and lower tumor burden (intra- or extrahepatic) to be independently associated with higher survival after hepatic RE. Optimal selection of patients with CRC liver metastases may improve survival rates after administration of yttrium-90.

Original languageEnglish
Pages (from-to)1094-1100
Number of pages7
JournalJournal of Vascular and Interventional Radiology
Volume29
Issue number8
DOIs
StatePublished - Aug 2018

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