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Hepatic Neuroendocrine Metastases: Chemo- or Bland Embolization?

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

Aggressive management of hepatic neuroendocrine (NE) metastases improves symptoms and prolongs survival. Because of the rarity of these tumors, however, the best method for hepatic artery embolization has not been established. We hypothesized that in patients with hepatic NE metastases, hepatic artery chemoembolization (HACE) would result in better symptom improvement and survival compared to bland embolization (HAE).

Methods

Retrospective review identified all patients with NE hepatic metastases managed by HACE or HAE at three institutions from January 1996 through December 2007.

Results

We identified 100 patients managed by HACE (n = 49) or HAE (n = 51) that were similar with respect to age, gender, and primary tumor type. The percentage of patients experiencing morbidity, 30-day mortality, and symptom improvement were similar between the two groups (HACE vs. HAE: 2.4% vs. 6.6%; 0.8% vs. 1.8%; and 88% vs. 83%, respectively.) No differences in the median overall survival were observed between HACE and HAE from the time of the first embolization procedure (25.5 vs. 25.7 months, p = 0.79). Multivariate analysis revealed that resection of the primary tumor predicted survival (73.8 vs. 19.4 months, p < 0.04).

Conclusions

These data suggest that morbidity, mortality, symptom improvement, and overall survival are similar in patients with hepatic neuroendocrine metastases managed by chemo- or bland hepatic artery embolization.

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Acknowledgement

This work was supported by the American College of Surgeons Resident Research Scholarship and National Institutes of Health Grant T32 CA009614 Physician Scientist Training in Cancer Medicine.

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Authors and Affiliations

  1. Department of Surgery, Indiana University, 535 Barnhill Dr., RT103D, Indianapolis, IN, 46, USA

    Susan C. Pitt, Jaime Knuth & Henry A. Pitt

  2. Department of Surgery, University of Wisconsin, Madison, WI, USA

    Susan C. Pitt, Sharon M. Weber & Hebert Chen

  3. Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA

    James M. Keily & Edward J. Quebbeman

  4. Department of Radiology, University of Wisconsin, Madison, WI, USA

    John C. McDermott

  5. Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, USA

    William S. Rilling

  6. Department of Radiology, Indiana University, 535 Barnhill Dr., RT103D, Indianapolis, IN, 46, USA

    David M. Agarwal

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  1. Susan C. Pitt
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Correspondence to Henry A. Pitt.

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Grant Support American College of Surgeons Resident Research Scholarship, National Institutes of Health Grant T32 CA009614 Physician Scientist Training in Cancer Medicine.

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Pitt, S.C., Knuth, J., Keily, J.M. et al. Hepatic Neuroendocrine Metastases: Chemo- or Bland Embolization?. J Gastrointest Surg 12, 1951–1960 (2008). https://doi.org/10.1007/s11605-008-0640-6

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  • DOI: https://doi.org/10.1007/s11605-008-0640-6

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