Abstract No. 462 Outcomes in patients over 70-years undergoing TIPS procedure: a single-center 10-year retrospective review

Abstract

To assess the effects of preoperative hemoglobin levels on treatment response to Y90 radioembolization in hepatocellular carcinoma Materials and Methods: Patients undergoing Y90 therapy for HCC at a single institution between September 2018 and MONTH 2020 were retrospectively analyzed. Data were collected from the EMR. Hemoglobin levels immediately prior to Y90 were recorded as well as treatment location, radiation dose/volume (Gray/cc). Follow-up imaging reports were reviewed for tumor response as per modified RECIST criteria. Patients were then stratified into cohorts: 1 group less than the 50th percentile hemoglobin for the cohort and 1 group more than the 50th percentile hemoglobin for the cohort. These two groups were then subdivided into positive response to therapy (partial response or complete response) or nonpositive response to therapy (stable disease or progression of disease). Chi-square test was performed to assess the statistical significance between treatment response and hemoglobin levels. Results: 161 total patients (mean age, 66 years; 101 men) received Y90 therapy for HCC. The 50th percentile hemoglobin value was calculated at 12.5. 85 patients (mean age, 65 years; 42 men) had a hemoglobin less than this and 76 patients (mean age, 67 years; 59 men) had a hemoglobin more than the 50th percentile value. The bottom 50th percentile ("anemic") cohort had a mean hgb level of 10.6 g/dL; and the top 50th percentile ("non-anemic") cohort of 14.2 g/dL. There was no significant difference in size of tumor treated between the two groups (3.4 cm vs. 2.4 cm, P ¼ 0.166). There was no significant difference in standardized radiation dose (Gray/cc) administered between the two cohorts (P ¼ 0.24). Chi-square analysis showed no significant difference in treatment response between anemic and non-anemic groups (P ¼ 0.24). Conclusions: Anemic patients did not show a poorer tumor response to Y90 radioembolization as compared to non-anemic patients despite the fact that beta-particle induced damage and reactive oxygen species production play a role in the mechanism of tumor death.

Transjugular Intrahepatic Portosystemic Shunt Outcomes in the Elderly Population: A Systematic Review and Meta-Analysis

“…Six studies with a total of 1,591 patients met our inclusion criteria and were included in the final meta-analysis [28][29][30][31][32][33]. Three studies divided patients by age < 65 vs. > 65 years, with a total of 816 patients who were 54% male.…”

“…1) elaborates our systematic literature search process. Baseline characteristics, including patient demographics and indications for TIPS, are reported in Tables 2 and 3 [28][29][30][31][32][33]. Publication bias was not assessed due to the low number of studies.…”

“…MINORS was used to assess the quality of the studies (Table 1) [28][29][30][31][32][33]. Non-comparative studies were graded on eight MINORS criteria, with each item ranging from 0 to 2 (0 if not reported; 1 if reported but inadequate; 2 if reported and adequate), and a global score of 16 for non-comparative studies and 24 for comparative analyses considered ideal.…”