{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T17:36:31Z","timestamp":1788456991262,"version":"build-2803163510"},"reference-count":43,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Selective internal radiation therapy (SIRT) with yttrium-90 microspheres has become an established locoregional treatment for hepatocellular carcinoma (HCC). Nevertheless, real-world data on clinical outcomes, including efficacy, safety, and prognostic determinants, remain limited. Methods: This study retrospectively analysed 56 patients with radiologically and\/or histologically confirmed HCC who underwent SIRT at a tertiary referral centre. Baseline demographics, clinical information, tumour characteristics, procedural data, and follow-up outcomes were recorded. The primary endpoints were overall survival (OS) and progression-free survival (PFS). Secondary outcomes included radiological response (mRECIST), histological necrosis, and treatment-related toxicity. Prognostic pathways were explored using structural equation modelling (SEM). Results: The mean age at the beginning of SIRT was 65.0 \u00b1 11.6 years; most patients were male (87.5%) and had preserved liver function (mean ALBI \u22122.9 \u00b1 0.4). BCLC staging distribution was 50% stage A, 32.1% stage B, and 17.9% stage C. According to mRECIST criteria at 6 months, 15.2% achieved complete response (CR), 47.8% partial response (PR), 30% stable disease (SD), and 7% progressive disease (PD). Median OS was 19 months (12\u201332) for BCLC stage A, 28 months (3\u201342) for stage B, and 19 months (12\u201356) for stage C (log-rank p = 0.743). SEM identified diffuse tumour morphology as the most significant predictor of poor prognosis. Radical treatments were performed in 28% of patients, including four liver transplants and ten resections. Adverse events occurred in 11 patients, of which 7 were Clavien\u2013Dindo grade I and 4 were grade II. Conclusions: In this real-world HCC group, SIRT provided durable tumour control and survival with excellent tolerability.<\/jats:p>","DOI":"10.3390\/jcm15041582","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T07:50:30Z","timestamp":1771401030000},"page":"1582","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Selective Internal Radiation Therapy (SIRT) for Hepatocellular Carcinoma: Real-World Experience from a Tertiary Care Centre"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1539-501X","authenticated-orcid":false,"given":"I.","family":"Ergenc","sequence":"first","affiliation":[{"name":"Department of Hepatology, Institute of Liver Studies, King\u2019s College Hospital, London SE5 9RS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9708-8245","authenticated-orcid":false,"given":"M.","family":"Guerra Veloz","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Institute of Liver Studies, King\u2019s College Hospital, London SE5 9RS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2626-4341","authenticated-orcid":false,"given":"M.","family":"Seager","sequence":"additional","affiliation":[{"name":"Department of Radiology, King\u2019s College Hospital, London SE5 9RS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4775-1800","authenticated-orcid":false,"given":"N.","family":"Heraghty","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, King\u2019s College Hospital, London SE5 9RS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1629-350X","authenticated-orcid":false,"given":"N.","family":"Kibriya","sequence":"additional","affiliation":[{"name":"Department of Radiology, King\u2019s College Hospital, London SE5 9RS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Green","sequence":"additional","affiliation":[{"name":"Department of Radiology, King\u2019s College Hospital, London SE5 9RS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Koundouraki","sequence":"additional","affiliation":[{"name":"Department of Radiology, King\u2019s College Hospital, London SE5 9RS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2973-1948","authenticated-orcid":false,"given":"S.","family":"Selemani","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Institute of Liver Studies, King\u2019s College Hospital, London SE5 9RS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Menon","sequence":"additional","affiliation":[{"name":"Department of Liver Transplant Surgery, Institute of Liver Studies, King\u2019s College Hospital, London SE5 9RS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7414-0186","authenticated-orcid":false,"given":"R.","family":"Miquel","sequence":"additional","affiliation":[{"name":"Department of Histology, Institute of Liver Studies, King\u2019s College Hospital, London SE5 9RS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2390-1886","authenticated-orcid":false,"given":"P.","family":"Ross","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, King\u2019s College Hospital, London SE5 9RS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4044-0500","authenticated-orcid":false,"given":"P.","family":"Peddu","sequence":"additional","affiliation":[{"name":"Department of Radiology, King\u2019s College Hospital, London SE5 9RS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2415-5352","authenticated-orcid":false,"given":"A.","family":"Suddle","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Institute of Liver Studies, King\u2019s College Hospital, London SE5 9RS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"ref_1","first-page":"209","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. 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