Meeting the combined exercise guideline has favorable associations with QoL in KCS, however, very few KCS are meeting the combined guideline.

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In this study we show overall survival (OS) outcomes of BCLC D patients treated with Y90 radioembolization (Y90). Materials: With IRB approval, we searched our prospectively acquired HCC database. Inclusion criteria included BCLC D patients who underwent Y90 between 2004 and 2017. Baseline tumor characteristics were evaluated. New laboratory toxicities at 1-month post Y90 were recorded. OS was estimated using Kaplan Meier method from date of Y90. Results: 44 patients with HCC and CP C (BCLC D) received 53 Y90 treatments. 34 (77%) were male; mean (range) age was 62 (47-85) years. 23 (52%) had T1/T2 tumors, 4 (10%) had T3, 8 (20%) T4a, 9 (20%) T4b and 2 (5%) patients had metastases at baseline. Only 6 (14%) patients showed new grade 3/4 bilirubin toxicities while 3 (7%) exhibited new grade 3 albumin toxicity at 1-month after Y90. 14 (32%) patients underwent subsequent liver transplantation (LT). Median time to LT was 4.5 months. Of the 14 patients that received LT, 93% (13/14) had T2 tumors at time of Y90. Transplanted organs used included living donor LT (n ¼ 3), donor after cardiac death (DCD) or CDC high risk or both (n ¼ 4), split (n ¼ 1), donor after brain death (DBD) (n ¼ 5). HCC MELD upgrade was responsible 57% of allocated organ. 3 received LDLT and 3 were transplanted based on native MELD with a DBD (40, 40 and 25). ITT median OSl was 14.8 months (95% CI: 4.8-21.3). Median OS for 14 patients who underwent OLT was not reached at 6-years, with 92% alive at year 5. Conclusions: Recently, the BCLC algorithm has included transplantation for BCLC D disease. We demonstrate that long-term survival may be seen in select BCLC D patients treated with Y90.