Survival after Yttrium-90 radioembolization in elderly and nonelderly patients with hepatocellular carcinoma or colorectal cancer liver metastases.

449 Background: Systemic treatment of unresectable hepatocellular carcinoma (HCC) or colorectal cancer liver metastases (CLM) in the elderly can be complicated by increased toxicity. In addition, the increasing incidence of comorbidities with age may preclude surgical resection with curative intent. Hepatic arterial therapy is increasingly utilized in patients with HCC or CLM not amenable to surgical resection. Studies of transarterial chemoembolization in the elderly have generally shown similar safety and efficacy as compared to younger patients, although some studies suggest worse outcomes. The selective nature of radioembolization has the potential for improved tolerability in this patient population. Methods: We report the results of a retrospective review of patients with unresectable HCC or metastatic disease to the liver treated with Yttrium-90 radioembolization at a single institution. Results: Patients were referred for treatment after multidisciplinary evaluation, but were not treated as part of a clinical trial. A total of 94 patients treated were evaluable for follow up. There were approximately twice as many males as females (64% vs 36%). Elderly was defined as 70 years of age or older, representing 20 of the 94 patients. Average age of the elderly cohort was 76 (range 70-90), compared to 56 years of age (range 23-69) for the younger patients. Survival was measured from date of first radioembolization. Median survival was similar for elderly and younger patients when considering all tumor types (337 days vs 288 days). There was no difference in median survival between elderly and non-elderly patients with CLM (377 days vs 365 days) or with HCC (370 days vs 363 days). Conclusions: In our experience, survival after Yttrium-90 radioembolization in elderly and younger patients with primary HCC or CLM is similar. Age alone should not preclude consideration for liver-directed therapy.