Good embolization response for colorectal liver metastases with hypervascularity.
OBJECTIVE
We investigated whether tumor hypervascularity in diagnostic images predicts response to transcatheter arterial embolization in colorectal liver metastases.


METHODS
Forty-five patients undergoing transcatheter arterial embolization for liver metastases were grouped by tumor vascularity on contrast-enhanced computed tomography and angiography. Group IA (n = 10) included patients with hypervascular tumors by both contrast-enhanced computed tomography and early-phase angiography; group IB (n = 15), hypervascularity by contrast-enhanced computed tomography and only late-phase angiography; group IIB (n = 2), hypovascularity by contrast-enhanced computed tomography and only early-phase angiography; group IIC (n = 18), hypovascularity by contrast-enhanced computed tomography and both angiography phases (unmentioned groups included no patients). Tumor response assessed by computed tomography and changes in serum carcinoembryonic antigen concentration at 1 month, as well as survival rates, were compared between groups.


RESULTS
Patients with a partial response numbered only 5, all in group IA. Patients with no change included 26 (group IA, 4; group IB, 10; group IIB, 1; group IIC, 11), while patients with progressive disease numbered 14 (group IA, 1; group IB, 5; group IIB, 1; group IIC, 7). Serum carcinoembryonic antigen concentrations were 0.62, 1.03, 1.31, and 2.01% of pretreatment rates in groups IA, IB, IIB, and IIC, respectively. Carcinoembryonic antigen increases in group IA plus IB were significantly lower (P = 0.04) than in group IIB plus IIC. The decreases in group IA differed significantly from changes in group IB plus IIB (P = 0.05), or group IIC (P = 0.02). Survival rates were somewhat higher group IA than in other, but not significantly.


CONCLUSIONS
Transcatheter arterial embolization is effective against colorectal liver metastases only when hypervascularity is evident.
Taniai
Nobuhiko
N
First Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyou-ku, Tokyo 113-8603, Japan.
Onda
Masahiko
M
Tajiri
Takashi
T
Furukawa
Kiyonori
K
Takasaki
Hideaki
H
Yoshimura
Kazuyasu
K
Yoshida
Hiroshi
H
Mamada
Yasuhiro
Y
Akimaru
Koho
K
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000628:therapy*; D003287:Contrast Media; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D003287:Contrast Media