Trifluridine-tipiracil versus radioembolization for patients with refractory colorectal liver metastases: A real-world data analysis.

160 Background: Liver-directed and systemic therapies are available for refractory colorectal liver metastases (CRLM), but comparative survival evidence between selective internal radiation therapy (SIRT) and trifluridine/tipiracil (FTD/TPI) is lacking. Furthermore, the optimal selection of patients who benefit most from SIRT can be improved. Methods: Patients with CRLM treated with SIRT or FTD/TPI (2015-2023) were identified from the Netherlands Cancer Registry. To adjust for baseline imbalances, standardized mortality ratio weighting (SMRW) was applied in the total cohort and stabilized inverse probability of treatment weighting (sIPTW) in the liver-only subgroup. Overall survival (OS) was analyzed using weighted Cox models and adjusted Kaplan–Meier curves. Prespecified subgroups included time from metastatic diagnosis to treatment (