Liver embolizations in oncology: a review. Part I. Arterial (chemo)embolizations

Arterial embolization of the liver often temporarily retards the growth of liver tumors which are mainly nourished arterially. The use of degradable agents avoids collateral formation which would prohibit repeat procedures and permit tumor regrowth. The effect of embolizations is largest in small hypervascular lesions, e.g., many hepatocellular or neuroendocrine cancers. Toxic chemicals can be added, chemoembolization, with unproven effects on responses and survival rates. Institutional differences in indications and procedures make evaluation of embolizations difficult. However, intermediate-term survival increases in selected cases of unresectable hepatocellular cancers and hormonal symptoms from neuroendocrine tumors often improve. Scant experience supports embolization for anti-tumoral effects in some pediatric tumors, to control bleeding from ruptured tumors, for symptomatic hemangiomas, and for downstaging of hepatocellular cancers before transplantation.