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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 1/2017

01-01-2017 | Clinical Investigation

Embolotherapy for Neuroendocrine Tumor Liver Metastases: Prognostic Factors for Hepatic Progression-Free Survival and Overall Survival

Authors: James X. Chen, Steven Rose, Sarah B. White, Ghassan El-Haddad, Nicholas Fidelman, Hooman Yarmohammadi, Winifred Hwang, Daniel Y. Sze, Nishita Kothary, Kristen Stashek, E. Paul Wileyto, Riad Salem, David C. Metz, Michael C. Soulen

Published in: CardioVascular and Interventional Radiology | Issue 1/2017

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Abstract

Purpose

The purpose of the study was to evaluate prognostic factors for survival outcomes following embolotherapy for neuroendocrine tumor (NET) liver metastases.

Materials and Methods

This was a multicenter retrospective study of 155 patients (60 years mean age, 57 % male) with NET liver metastases from pancreas (n = 71), gut (n = 68), lung (n = 8), or other/unknown (n = 8) primary sites treated with conventional transarterial chemoembolization (TACE, n = 50), transarterial radioembolization (TARE, n = 64), or transarterial embolization (TAE, n = 41) between 2004 and 2015. Patient-, tumor-, and treatment-related factors were evaluated for prognostic effect on hepatic progression-free survival (HPFS) and overall survival (OS) using unadjusted and propensity score-weighted univariate and multivariate Cox proportional hazards models.

Results

Median HPFS and OS were 18.5 and 125.1 months for G1 (n = 75), 12.2 and 33.9 months for G2 (n = 60), and 4.9 and 9.3 months for G3 tumors (n = 20), respectively (p < 0.05). Tumor burden >50 % hepatic volume demonstrated 5.5- and 26.8-month shorter median HPFS and OS, respectively, versus burden ≤50 % (p < 0.05). There were no significant differences in HPFS or OS between gut or pancreas primaries. In multivariate HPFS analysis, there were no significant differences among embolotherapy modalities. In multivariate OS analysis, TARE had a higher hazard ratio than TACE (unadjusted Cox model: HR 2.1, p = 0.02; propensity score adjusted model: HR 1.8, p = 0.11), while TAE did not differ significantly from TACE.

Conclusion

Higher tumor grade and tumor burden prognosticated shorter HPFS and OS. TARE had a higher hazard ratio for OS than TACE. There were no significant differences in HPFS among embolotherapy modalities.
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Metadata
Title
Embolotherapy for Neuroendocrine Tumor Liver Metastases: Prognostic Factors for Hepatic Progression-Free Survival and Overall Survival
Authors
James X. Chen
Steven Rose
Sarah B. White
Ghassan El-Haddad
Nicholas Fidelman
Hooman Yarmohammadi
Winifred Hwang
Daniel Y. Sze
Nishita Kothary
Kristen Stashek
E. Paul Wileyto
Riad Salem
David C. Metz
Michael C. Soulen
Publication date
01-01-2017
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 1/2017
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-016-1478-z

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