Hepatic neuroendocrine metastases: chemo- or bland embolization? J Gastrointest Surg 2008 Nov;12(11):1951-60
Date
08/19/2008Pubmed ID
18709512Pubmed Central ID
PMC3342849DOI
10.1007/s11605-008-0640-6Scopus ID
2-s2.0-54349122462 (requires institutional sign-in at Scopus site) 88 CitationsAbstract
INTRODUCTION: Aggressive management of hepatic neuroendocrine (NE) metastases improves symptoms and prolongs survival. Because of the rarity of these tumors, however, the best method for hepatic artery embolization has not been established. We hypothesized that in patients with hepatic NE metastases, hepatic artery chemoembolization (HACE) would result in better symptom improvement and survival compared to bland embolization (HAE).
METHODS: Retrospective review identified all patients with NE hepatic metastases managed by HACE or HAE at three institutions from January 1996 through December 2007.
RESULTS: We identified 100 patients managed by HACE (n = 49) or HAE (n = 51) that were similar with respect to age, gender, and primary tumor type. The percentage of patients experiencing morbidity, 30-day mortality, and symptom improvement were similar between the two groups (HACE vs. HAE: 2.4% vs. 6.6%; 0.8% vs. 1.8%; and 88% vs. 83%, respectively.) No differences in the median overall survival were observed between HACE and HAE from the time of the first embolization procedure (25.5 vs. 25.7 months, p = 0.79). Multivariate analysis revealed that resection of the primary tumor predicted survival (73.8 vs. 19.4 months, p < 0.04).
CONCLUSIONS: These data suggest that morbidity, mortality, symptom improvement, and overall survival are similar in patients with hepatic neuroendocrine metastases managed by chemo- or bland hepatic artery embolization.
Author List
Pitt SC, Knuth J, Keily JM, McDermott JC, Weber SM, Chen H, Rilling WS, Quebbeman EJ, Agarwal DM, Pitt HAAuthor
William S. Rilling MD, FSIR Vice Chair, Professor in the Radiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Chemoembolization, TherapeuticEmbolization, Therapeutic
Female
Follow-Up Studies
Hepatic Artery
Humans
Kaplan-Meier Estimate
Liver Neoplasms
Male
Middle Aged
Neoplasm Staging
Neuroendocrine Tumors
Probability
Retrospective Studies
Risk Assessment
Statistics, Nonparametric
Survival Rate
Tomography, X-Ray Computed
Treatment Outcome
