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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 2/2015

01-04-2015 | Clinical Investigation

Predisposing Factors of Liver Necrosis after Transcatheter Arterial Chemoembolization in Liver Metastases from Neuroendocrine Tumor

Authors: Julien Joskin, Thierry de Baere, Anne Auperin, Lambros Tselikas, Boris Guiu, Geoffroy Farouil, Valérie Boige, David Malka, Sophie Leboulleux, Michel Ducreux, Eric Baudin, Frédéric Deschamps

Published in: CardioVascular and Interventional Radiology | Issue 2/2015

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Abstract

Purpose

To investigate predictive factors for liver necrosis after transcatheter arterial chemoembolization (TACE) of neuroendocrine liver metastases.

Methods

A total of 164 patients receiving 374 TACE were reviewed retrospectively to analyze predictive factors of liver necrosis. We analyzed patient age and sex; metastasis number and location; percentage of liver involvement; baseline liver function test; and pretreatment imaging abnormalities such as bile duct dilatation (BDD), portal vein narrowing (PVN), and portal vein thrombosis (PVT). We analyzed TACE technique such as Lipiodol or drug-eluting beads (DEB) as the drug’s vector; dose of chemotherapy; diameter of DEB; and number, frequency, and selectivity of TACE.

Results

Liver necrosis developed after 23 (6.1 %) of 374 TACE. In multivariate analysis, DEB > 300 μm in size induced more liver necrosis compared to Lipiodol (odds ratio [OR] 35.20; p < 0.0001) or with DEB < 300 μm in size (OR 19.95; p < 0.010). Pretreatment BDD (OR 119.64; p < 0.0001) and PVT (OR 9.83; p = 0.030) were predictive of liver necrosis. BDD or PVT responsible for liver necrosis were present before TACE in 59 % (13 of 22) and were induced by a previous TACE in 41 % (9 of 22) of cases.

Conclusion

DEB > 300 μm in size, BDD, and PVT are responsible for increased rate of liver necrosis after TACE. Careful analysis of BDD or PVT on pretreatment images as well as images taken between two courses can help avoid TACE complications.
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Metadata
Title
Predisposing Factors of Liver Necrosis after Transcatheter Arterial Chemoembolization in Liver Metastases from Neuroendocrine Tumor
Authors
Julien Joskin
Thierry de Baere
Anne Auperin
Lambros Tselikas
Boris Guiu
Geoffroy Farouil
Valérie Boige
David Malka
Sophie Leboulleux
Michel Ducreux
Eric Baudin
Frédéric Deschamps
Publication date
01-04-2015
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 2/2015
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-014-0914-1

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