Hepatic neuroendocrine metastases: chemo- or bland embolization?
Susan C Pitt1, Jaime Knuth, James M Keily
1Department of Surgery, Indiana University, 535 Barnhill Dr., RT103D, Indianapolis, IN, USA.
Summary
Hepatic artery embolization for neuroendocrine metastases shows similar outcomes whether using chemotherapy (HACE) or bland agents (HAE). Both methods offer comparable symptom improvement and survival rates for patients with liver neuroendocrine tumors.
Area of Science:
- Oncology
- Interventional Radiology
- Hepatobiliary Surgery
Background:
- Hepatic neuroendocrine (NE) metastases require aggressive management for symptom control and survival.
- Optimal hepatic artery embolization techniques for NE metastases remain undefined due to tumor rarity.
Purpose of the Study:
- To compare the efficacy of hepatic artery chemoembolization (HACE) versus bland hepatic artery embolization (HAE) in patients with hepatic NE metastases.
- To evaluate differences in symptom improvement, morbidity, mortality, and overall survival between HACE and HAE.
Main Methods:
- Retrospective review of 100 patients with hepatic NE metastases treated with HACE (n=49) or HAE (n=51) across three institutions (1996-2007).
- Comparison of patient demographics, primary tumor types, morbidity, 30-day mortality, symptom improvement, and overall survival between the two embolization groups.
Main Results:
- No significant differences were observed in morbidity (2.4% vs. 6.6%), 30-day mortality (0.8% vs. 1.8%), or symptom improvement (88% vs. 83%) between HACE and HAE.
- Median overall survival was similar for both groups (25.5 vs. 25.7 months, p=0.79).
- Resection of the primary tumor was a significant predictor of improved survival (73.8 vs. 19.4 months, p<0.04).
Conclusions:
- Chemoembolization (HACE) and bland embolization (HAE) demonstrate comparable outcomes regarding morbidity, mortality, symptom relief, and survival in hepatic neuroendocrine metastases.
- These findings suggest that the choice between HACE and HAE may not significantly impact patient outcomes for this specific indication.
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