Comparison of the survival and tolerability of radioembolization in elderly vs. younger patients with unresectable hepatocellular carcinoma

background & aims: the european network on radioembolization with Yttrium-90 resin microspheres study group (ENRY) conducted a retrospective study to evaluate the outcomes among elderly (≥ 70 years) and younger patients (<70 years) with unresectable hepatocellular carcinoma (HCC) who received radioembolization at 8 european centers. methods: patients with confirmed diagnosis of unresectable HCC who either progressed following resection or locoregional treatment and/or who were considered poor candidates for chemoembolization were evaluated by a multidisciplinary team for radioembolization with (90)Y-resin microspheres (SIR-spheres; sirtex medical). the survival outcome and all adverse events were compared between the two age groups. results: between 2003 and 2009, 128 elderly and 197 younger patients received radioembolization. patients in both groups had similar demographic characteristics. many elderly and younger patients alike had multinodular, BCLC stage C disease, invading both lobes (p = 0.648). elderly patients had a lower tumor burden, a smaller median target liver volume (p = 0.016) and appeared more likely to receive segmental treatment (p = 0.054). radioembolization was equally well tolerated in both cohorts and common procedure-related adverse events were predominantly grade 1-2 and of short duration. no significant differences in survival between the groups were found (p = 0.942) with similar median survival in patients with early, intermediate or advanced BCLC stage disease. conclusions: radioembolization appears to be as well-tolerated and effective for the elderly as it is for younger patients with unresectable HCC. age alone should not be a discriminating factor for the management of HCC patients.