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. 2008;10(6):396-404.
doi: 10.1080/13651820802356564.

Treatment response to transcatheter arterial embolization and chemoembolization in primary and metastatic tumors of the liver

Avo Artinyan  1 , Rebecca Nelson, Perry Soriano, Vincent Chung, Janet Retseck, Jonathon Reynolds, Howard Marx, Joseph Kim, Lawrence Wagman
Affiliations

Treatment response to transcatheter arterial embolization and chemoembolization in primary and metastatic tumors of the liver

Avo Artinyan et al. HPB (Oxford). 2008.

Abstract

Introduction: Transcatheter arterial embolization (TAE) and chemoembolization (TACE) are increasingly used to treat unresectable primary and metastatic liver tumors. The purpose of this study was to determine the objective response to TAE and TACE in unresectable hepatic malignancies and to identify clinicopathologic predictors of response.

Materials and methods: Seventy-nine consecutive patients who underwent 119 TAE/TACE procedures between 1998 and 2006 were reviewed. The change in maximal diameter of 121 evaluable lesions in 56 patients was calculated from pre and post-procedure imaging. Response rates were determined using Response Evaluation Criteria in Solid Tumors (RECIST) guidelines. The Kaplan-Meier method was used to compare survival in responders vs. non-responders and in primary vs. metastatic histologies.

Results: TAE and TACE resulted in a mean decrease in lesion size of 10.3%+/-1.9% (p<0.001). TACE (vs. TAE) and carcinoid tumors were associated with a greater response (p<0.05). Lesion response was not predicted by pre-treatment size, vascularity, or histology. The RECIST partial response (PR) rate was 12.3% and all partial responders were in the TACE group. Neuroendocrine tumors, and specifically carcinoid lesions, had a significantly greater PR rate (p<0.05). Overall survival, however, was not associated with histology or radiologic response.

Discussion: TAE and TACE produce a significant objective treatment response by RECIST criteria. Response is greatest in neuroendocrine tumors and is independent of vascularity and lesion size. TACE appears to be superior to TAE. Although an association of response with improved survival was not demonstrated, large cohort studies are necessary to further define this relationship.

Keywords: RECIST; chemoembolization; regional therapy.

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Figures

Figure 1.
Figure 1.
Survival estimates stratified by histology.
Figure 2.
Figure 2.
Survival estimates stratified by response.
See this image and copyright information in PMC

References

    1. Llovet JM. Updated treatment approach to hepatocellular carcinoma. J Gastroenterol. 2005;40(3):225–35. - PubMed
    1. Liapi E, Geschwind JF. Transcatheter and ablative therapeutic approaches for solid malignancies. J Clin Oncol. 2007;25(8):978–86. - PubMed
    1. Stuart K. Chemoembolization in the management of liver tumors. Oncologist. 2003;8(5):425–37. - PubMed
    1. Sullivan KL. Hepatic artery chemoembolization. Semin Oncol. 2002;29(2):145–51. - PubMed
    1. Patt YZ, Chuang VP, Wallace S, Benjamin RS, Fuqua R, Mavligit GM. Hepatic arterial chemotherapy and occlusion for palliation of primary hepatocellular and unknown primary neoplasms in the liver. Cancer. 1983;51(8):1359–63. - PubMed