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Transarterial chemoembolization of unresectable systemic chemotherapy refractory liver metastases: a retrospective single-center analysis

  • Interventional Radiology
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to evaluate the therapeutic efficacy and safety of transarterial chemoembolization (TACE) in the treatment of patients with unresectable colorectal cancer liver metastases (CRCLM) who had failed systemic chemotherapy. In addition, the role of TACE in the treatment of CRCLM is also worth discussing.

Methods

This single-center retrospective study evaluated the consecutive medical records of patients with CRCLM treated with TACE from June 2014 to June 2018, who had failed at least two lines of prior chemotherapy. Therapeutic response, overall survival (OS), progression-free survival (PFS), and complications were recorded.

Results

Fifty-three eligible patients were included in our study. The objective tumor radiologic regression and disease control rates were 52.8% and 79.2%, respectively. Median OS and PFS were 15 months (95% confidence interval [CI] 13.1 months, 16.9 months) and 6 months (95% CI 4.7 months, 7.3 months), respectively. Multivariate analysis found that synchronous metastatic disease, presence of extrahepatic metastasis, and Child-Pugh score B were independent prognostic factor for OS and PFS. Two patients (3.8%) had severe complications. The results of subgroup analysis showed that synchronous liver metastasis and extrahepatic metastasis had an effect on the prognosis of patients, while the primary tumor sites (rectum, left, and right colon) had no effect on the prognosis.

Conclusions

TACE is well tolerated and effective in patients with unresectable chemotherapy refractory CRCLM. Meanwhile, the results of this study also indicated that TACE is still a better treatment for these patients.

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Funding

This study was funded by grant from National Nature Science Fundation of China (Grant No. 81873917).

Data availability

Please contact the corresponding author for data request.

Abbreviations

CRCLM:

Colorectal cancer liver metastases

TACE:

Transarterial chemoembolization

ECOG:

Eastern Cooperative Oncology Group

CT:

Computed tomography

MR:

Magnetic resonance

ORR:

Objective tumor radiologic regression

DCR:

Disease control rate

mRECIST:

Modified Response Evaluation Criteria in Solid Tumors

CR:

Complete response

PR:

Partial response

SD:

Stable disease

OS:

Overall survival

PFS:

Progression-free survival

PD:

Progressive disease

CI:

Confidence interval

HR:

Hazard ratio

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Acknowledgements

This study was funded by grant from National Nature Science Foundation of China (Grant No. 81873917).

Author information

Author notes

  1. Yanqiao Ren, Lei Chen, and Songjiang Huang are equal contributors.

Authors and Affiliations

  1. Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Yanqiao Ren, Lei Chen, Songjiang Huang, Chen Zhou, Jiacheng Liu, Qin Shi, Chongtu Yang, Chuansheng Zheng, Ping Han & Bin Xiong

  2. Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China

    Yanqiao Ren, Lei Chen, Songjiang Huang, Chen Zhou, Jiacheng Liu, Qin Shi, Chongtu Yang, Chuansheng Zheng, Ping Han & Bin Xiong

  3. Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Renwang Chen

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  1. Yanqiao Ren
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Contributions

YR, LC, SH and CZ collected the patients’ data, YR drafted the manuscript. LC, SH revised the manuscript. CZ, JL, QS, CY and RC analyzed and interpreted the data. CZ made substantial contributions to the conception of the work. PH and BX made substantial contributions to the design of the work, and have revised the manuscript substantively. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Ping Han or Bin Xiong.

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Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

As a retrospective analysis, informed consent in this study was waived.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This retrospective study was approved by the institutional review board of the Union Hospital, Tongji Medical college, Huazhong University of Science and Technology.

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Ren, Y., Chen, L., Huang, S. et al. Transarterial chemoembolization of unresectable systemic chemotherapy refractory liver metastases: a retrospective single-center analysis. Abdom Radiol 45, 2862–2870 (2020). https://doi.org/10.1007/s00261-020-02584-6

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