An NCDB analysis of 82,161 patients with colorectal cancer metastatic to liver at time of diagnosis between 2010–2020 reveals Y-90 radioembolization utilization increased more than four-fold over the decade, rising from 216 to 874 treatments per 100,000 patients. Y-90 recipients were more likely to be younger, privately insured, have fewer comorbidities, and receive systemic chemotherapy. Yet, after multivariable adjustment, Y-90 was not associated with improved overall survival, mirroring several prior randomized studies including SIRFLOX, FOXFIRE, and FOXFIRE-Global which demonstrated improvements in liver control but failed to move overall survival times. Notably, utilization accelerated after publication of several of these negative trials. | Luo, J Clin Oncol 2026
