Permanent transarterial embolization of neuroendocrine metastases of the liver using cyanoacrylate and lipiodol: assessment of mid- and long-term results.
OBJECTIVE
The purpose of our study was to assess the results of hepatic artery embolization using N-butyl-2-cyanoacrylate and ethiodized oil for the treatment of small-bowel neuroendocrine metastases to the liver as part of a multimodality protocol for the treatment of liver metastases from neuroendocrine small-bowel tumors.


METHODS
Twenty-three patients underwent permanent embolization of the hepatic artery using cyanoacrylate and Lipiodol for treatment of liver metastases after radical resection of small-bowel neuroendocrine tumors. All patients received additional treatment including somatostatin, and most patients received interferon as well. Cumulative survival rates were estimated using the Kaplan-Meier method.


RESULTS
Overall, 75 embolizations (range, 1-10; mean, 3.3) were performed. Median survival time was 69 months, and the estimated cumulative survival rates reached 95.7% and 65.4% for 1 and 5 years, respectively. Two deaths (8.7%) occurred within 1 month of treatment, and one patient experienced a vascular complication at the time of embolization.


CONCLUSIONS
Permanent embolization of hepatic arteries as part of a multimodality treatment protocol is beneficial in long-term follow-up for patients with metastasized small-bowel neuroendocrine tumors. The use of cyanoacrylate as an embolic agent is safe and effective.
Loewe
Christian
C
Department of Radiology, Division of Angiography and Interventional Radiology, University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
Schindl
Martin
M
Cejna
Manfred
M
Niederle
Bruno
B
Lammer
Johannes
J
Thurnher
Siegfried
S
D000328:Adult; D000368:Aged; D001158:Arteries; D016461:Chemoembolization, Therapeutic / Q000379:methods; D003487:Cyanoacrylates / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage*; D008113:Liver Neoplasms / Q000556:secondary* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors
D003487:Cyanoacrylates; D007459:Iodized Oil