Evidence map›Paper›PMID 42720825›Full record

ArticleJournal of gastrointestinal cancer2026

Predictors of Hepatic Decompensation Post-Y90 Treatment in Hepatocellular Carcinoma: New Insights into Segmental TARE and Post-Treatment Dosimetry.

Ali Afrasiabi, Bahareh Gholami, Andrew M Moon, Alex Villalobos, Johannes L Du Pisanie, Bryan Harris, Hyeon Yu, David Mauro, Paolo Varela, Michael Mohnasky and 3 more

Abstract read
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Article in Journal of gastrointestinal cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Ali AfrasiabiDivision of Vascular and Interventional Radiology, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27514, USA. Ali_Afrasiabi@med.unc.edu.
Bahareh GholamiDivision of Vascular and Interventional Radiology, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27514, USA.
Andrew M MoonDivision of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27514, USA.
Alex VillalobosDivision of Vascular and Interventional Radiology, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27514, USA.
Johannes L Du PisanieDivision of Vascular and Interventional Radiology, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27514, USA.
Bryan HarrisDivision of Vascular and Interventional Radiology, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27514, USA.
Hyeon YuDivision of Vascular and Interventional Radiology, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27514, USA.
David MauroDivision of Vascular and Interventional Radiology, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27514, USA.
Paolo VarelaDivision of Vascular and Interventional Radiology, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27514, USA.
Michael MohnaskyDivision of Vascular and Interventional Radiology, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27514, USA.
Sandra GadDivision of Vascular and Interventional Radiology, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27514, USA.
Nima KokabiDivision of Vascular and Interventional Radiology, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27514, USA.
FRCPC

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTransarterial radioembolization (TARE) with yttrium-90 (Y-90) microspheres is an established treatment for unresectable hepatocellular carcinoma (HCC). Although segmental TARE offers a favorable safety profile, hepatic decompensation remains a clinically important complication. This study aimed to identify clinical, laboratory, and post-treatment dosimetric predictors of hepatic decompensation following segmental Y-90 TARE.

methodsIn this retrospective cohort study, 102 patients with HCC who underwent segmental Y-90 TARE between 2015 and 2025 were analyzed. Baseline demographic, clinical, laboratory, and imaging data were collected. Hepatic decompensation was defined as new-onset ascites, new or worsening hepatic encephalopathy, or total bilirubin > 3× the upper limit of normal within 2-4 months after TARE, in the absence of radiographic tumor progression. Post-treatment dosimetry was performed using SPECT/CT images. Univariate and multivariable logistic regression models were used to identify predictors of hepatic decompensation.

resultsHepatic decompensation occurred in 14 patients (13.7%). On univariate analysis, decompensation was associated with baseline hypoalbuminemia (< 3.5 g/dL), higher MELD and ALBI scores, Child-Pugh class B/C, INR ≥ 1.2, lower white blood cell count, and higher alkaline phosphatase levels. Because target doses and normal-parenchyma tolerances differ between microsphere types, post-treatment dosimetry and volumetry were analyzed separately by platform. In the glass microsphere cohort, patients who developed decompensation received a lower mean absorbed dose to the treated segment (236 Gy vs. 411 Gy, p = 0.03), whereas no significant dosimetric or volumetric differences were observed in the resin microsphere cohort. In multivariable analysis, baseline hypoalbuminemia (< 3.5 g/dL) was the only independent predictor of hepatic decompensation (OR = 7.98, 95% CI 1.16-80.39, p = 0.04).

conclusionIn this retrospective cohort, hepatic decompensation following segmental Y-90 TARE appeared more strongly associated with impaired baseline hepatic reserve than with the post-treatment dosimetry parameters evaluated. Baseline hypoalbuminemia is a strong independent predictor of early hepatic decompensation and should be carefully considered during patient selection for radioembolization.

Indexed as

Carcinoma, HepatocellularLiver FailureLiver NeoplasmsRadioembolization, TherapeuticYttrium RadioisotopesAgedFemaleHumansMaleMicrospheresMiddle AgedRadiometryRadiotherapy DosageRetrospective StudiesSingle Photon Emission Computed Tomography Computed TomographyYttrium-90Yttrium RadioisotopesHepatic decompensationLiver cancerLocoregional therapyTransarterial radioembolization

Identifiers

PMID42720825

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.