e14721 Background: In patients with Locally advanced/metastatic HCC, the median survival is 3 months. Most of these patients have altered liver functions which makes them unsuitable for any therapy. In this exploratory study we aim to test the effectiveness of I-131-lipiodol in prolonging survival in these patients. Methods: 15 patients with locally advanced HCC (unresectable) and metastatic HCC with altered liver functions (CHILDS B and C) were given I-131-lipiodol. Patients had received prior chemotherapy, prior TACE therapy, prior sorafenib and had treatment refractory progressive disease. We compared effects of I-131-Lipiodol in prolonging survival beyond three months in these patients. We performed a non parametric one sample kolmogorov Smirnov test comparing survival with I-131-lipiodol to an average 90 days survival reported in patients with advanced HCC. Results: Survival ranged from 46 to 417 days with a median survival of 144 days. However one sample test showed significant improvement in survival with I-131-lipiodol therapy compared to standard of care (z = 1.4, p = 0.04). Conclusions: I-131-lipiodol is a useful local therapy in management of patients with advanced HCC, randomized controlled trials are needed to validate its findings in adjuvant and palliative settings.