title: Repetitive transarterial chemoembolization (TACE) of liver metastases from gastric cancer: local control and survival results.
abstract: OBJECTIVE
  To evaluate the local tumor control and survival data after transarterial chemoembolization with different drug combinations in the palliative treatment of patients with liver metastases of gastric cancer.
  
  
  METHODS
  The study was retrospectively performed. 56 patients (mean age, 52.4) with unresectable liver metastases of gastric cancer who did not respond to systemic chemotherapy were repeatedly treated with TACE in 4-week intervals. In total, 310 chemoembolization procedures were performed (mean, 5.5 sessions per patient). The local chemotherapy protocol consisted of mitomycin alone (30.4%), mitomycin and gemcitabine (33.9%), or mitomycin, gemcitabine and cisplatin (35.7%). Embolization was performed with lipiodol and starch microspheres. Local tumor response was evaluated by MRI according to RECIST. Survival data from first chemoembolization were calculated according to the Kaplan-Meier method.
  
  
  RESULTS
  The local tumor control was: complete response in 1.8% (n=1), partial response in 1.8% (n=1), stable disease in 51.8% (n=29) and progressive disease in 44.6% (n=25) of patients. The 1-, 2-, and 3-year survival rate from the start of chemoembolization were 58%, 38%, and 23% respectively. The median and mean survival times were 13 and 27.1 months. A Statistically significant difference between patients treated with different chemotherapy protocols was noted (ρ=0.045) with the best survival time in the mitomycin, gemcitabine and cisplatin group.
  
  
  CONCLUSIONS
  Transarterial chemoembolization is a minimally invasive therapy option for palliative treatment of liver metastases in patients with gastric cancer.
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University Frankfurt, Germany. T.Vogl@em.uni-frankfurt.de
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Vogl
authors.forename: Tatjana
authors.initials: T
authors.lastname: Gruber-Rouh
authors.forename: Katrin
authors.initials: K
authors.lastname: Eichler
authors.forename: Nour-Eldin A
authors.initials: NE
authors.lastname: Nour-Eldin
authors.forename: Jörg
authors.initials: J
authors.lastname: Trojan
authors.forename: Stephan
authors.initials: S
authors.lastname: Zangos
authors.forename: Nagy N N
authors.initials: NN
authors.lastname: Naguib
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D016461:Chemoembolization, Therapeutic / Q000401:mortality*; D018572:Disease-Free Survival; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000517:prevention & control*; D015995:Prevalence; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality* / Q000628:therapy*; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome