Yttrium-90 radiation segmentectomy of oligometastatic urothelial carcinoma

Many patients with primary or metastatic liver tumors are not surgical candidates or have lesions that are not amenable to thermal ablation. Radiation segmentectomy involves microcatheter delivery of an ablative dose of Yttrium-90 microspheres through arteries feeding hepatic malignancy. This treatment is performed with curative intent in hepatocellular carcinoma and has shown promising results in various hepatic metastases. However, many studies have paired radiation segmentectomy with systemic chemotherapy. This case report describes the outcomes of a chemotherapy naïve patient with urothelial carcinoma and oligometastatic spread to the liver treated with Yttrium-90 radiation segmentectomy (Y90RS). Initial treatment achieved disease control of metastasis until imaging at 15 months revealed local recurrence which was treated with repeat Y90RS. Throughout treatment, the patient remained at her functional baseline with normal labs and independence in activities of daily living.