title: Trans-catheter arterial chemoembolization as first-line treatment for hepatic metastases from endocrine tumors.
abstract: Our objective was to report the outcome in patients with liver metastasis from endocrine tumors who underwent transarterial chemoembolization (TACE) as first-line non-surgical treatment. From January 1990 to December 2000, 14 patients with progressive unresectable liver metastases from digestive neuroendocrine tumor were treated with TACE (mean of 3.6 sessions) before any non-surgical treatment (somatostatin analogue, chemotherapy or interferon). Liver involvement was less than 50% in 11 patients. Size of the largest lesion ranged from 1.5 to 10 cm. Ten patients presented with carcinoid symptoms. The TACE was performed with Doxorubicin emulsified in Lipiodol and gelatin sponge particles. Symptomatic response upon flushes and/or diarrhea was complete in 7 of 10 cases and partial in 2 of 10 cases. An objective morphologic response was noted in 12 of 14 cases. The 5- and 10-year survival rate from diagnosis was 83 and 56%, respectively. Six patients were alive at the end of the study after 27-100 months from first TACE and 38-142 months from diagnosis. Three of them were successfully palliated for 55, 69, and 100 months with only TACE as treatment. Long-term palliation is possible in unresectable liver metastases from digestive neuroendocrine tumors with a few sessions of TACE as first-line and eventually exclusive treatment.
authors.affiliation: Service de Radiologie Interventionnelle, Institut Gustave Roussy, rue Camille Desmoulins 39, 94805 Villejuif Cedex, France. roche@igr.fr
authors.forename: Alain
authors.initials: A
authors.lastname: Roche
authors.forename: Baragur V
authors.initials: BV
authors.lastname: Girish
authors.forename: Thierry
authors.initials: T
authors.lastname: de Baère
authors.forename: Eric
authors.initials: E
authors.lastname: Baudin
authors.forename: Valérie
authors.initials: V
authors.lastname: Boige
authors.forename: Dominique
authors.initials: D
authors.lastname: Elias
authors.forename: Philippe
authors.initials: P
authors.lastname: Lasser
authors.forename: Martin
authors.initials: M
authors.lastname: Schlumberger
authors.forename: Michel
authors.initials: M
authors.lastname: Ducreux
mesh_terms: D000328:Adult; D000368:Aged; D002276:Carcinoid Tumor / Q000401:mortality / Q000473:pathology*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms / Q000401:mortality / Q000473:pathology*; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D008297:Male; D008303:Malignant Carcinoid Syndrome / Q000628:therapy; D008875:Middle Aged; D010166:Palliative Care; D012189:Retrospective Studies; D015996:Survival Rate