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Cox-proportional hazards. A subanalysis for patients with high alpha-fetoprotein (AFP) (>100 ng/dl) was conducted. Results: 185 patients with HCC and tumor PVT had Y90. 43(23%) patients had segmental, 65(35%) had lobar, and 77(42%) had main PVT. 74 patients (40%) were CPA, 51(28%) were CPB7 and 60(32%) were CPB8. New grade 3/4 toxicities were seen in 29(16%) patients for bilirubin, 23(13%) for albumin, and 5(2.6%) for alkaline phosphatase. Median OS(months) (95% CI) for CPA, CPB7, and CPB8 patients was 13.3(8.7-15.7), 6.9(5.3-10.1), and 3.9(2.9-5.0), respectively. For CPA patients, median OS(months) (95% CI) was 14.3(12.0-17.8) for segmental, 14.2(7.3-19.5) for lobar and 7.7(4.6-13.8) for main [P ¼ 0.78]. For CPB7 patients, median OS (months) (95% CI) was 6.5(3.4-38) for segmental, 6.9(4.6-13.3) for lobar and 7.7(4.8-11.1) for main [P ¼ 0.82]. For CPB8 patients, median OS (months) (95% CI) was 8.4(1.2-75.2) for segmental, 4.4(2.5-9.7) for lobar and 3.4(2.5-4.6) for main [P ¼ 0.015]. Multivariate analysis showed baseline bilirubin, ascites, and AFP to be significant OS prognosticators. Out of 123 patients with high AFP, 12(10%) patients normalized their AFP levels (<13) with a median OS of 23.9 months (CI:20.1-124.1). Conclusions: Y90 can serve as a safe and effective treatment for advanced HCC patients with tumor PVT, particularly for those with preserved liver function. OS is affected by baseline liver function, tumor size, and AFP level. Location of PVT had a significant effect on OS in CPB8.

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