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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2013

01-04-2013 | Regional Cancer Therapies

Extrahepatic Disease Should Not Preclude Transarterial Chemoembolization for Metastatic Neuroendocrine Carcinoma

Authors: David Arrese, MD, Megan E. McNally, MD, Ravi Chokshi, MD, Enrique Feria-Arias, BS, Carl Schmidt, MD, MS, Dori Klemanski, DNP, CNP, Guy Gregory, MD, Hooman Khabiri, MD, Manisha Shah, MD, Mark Bloomston, MD

Published in: Annals of Surgical Oncology | Issue 4/2013

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Abstract

Background

Transarterial chemoembolization (TACE) is often utilized for patients with inoperable neuroendocrine carcinoma liver metastases. Often, metastatic disease is not limited to the liver. The impact of extrahepatic disease (EHD) on outcomes and response after TACE has not been described.

Methods

We reviewed 192 patients who underwent TACE for large hepatic tumor burden, progression of liver metastases, or poorly controlled carcinoid syndrome due to neuroendocrine carcinoma. Demographics, clinicopathologic characteristics, response to TACE, complications, and survival were compared between patients with (n = 123) and without (n = 69) EHD.

Results

Demographics, histopathologic characteristics, and complications were similar between groups. As well, those with and without EHD had similar biochemical (85 vs. 88 %) and radiographic response (76 vs. 79 %) to TACE (all p = NS); however, symptomatic responses were improved in those with EHD (79 vs. 60 %, p = 0.01). The group without EHD had better overall survival compared to those with EHD disease at the time of TACE (median 62 vs. 28 months, p = 0.001).

Discussion

Although patients with EHD from neuroendocrine carcinoma experience shorter overall survival after TACE compared to those without EHD, they had similar symptomatic, biochemical, and radiographic response to TACE. Meaningful response to TACE is still possible in the presence of EHD and should be considered, particularly in those with carcinoid syndrome.
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Metadata
Title
Extrahepatic Disease Should Not Preclude Transarterial Chemoembolization for Metastatic Neuroendocrine Carcinoma
Authors
David Arrese, MD
Megan E. McNally, MD
Ravi Chokshi, MD
Enrique Feria-Arias, BS
Carl Schmidt, MD, MS
Dori Klemanski, DNP, CNP
Guy Gregory, MD
Hooman Khabiri, MD
Manisha Shah, MD
Mark Bloomston, MD
Publication date
01-04-2013
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 4/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-012-2786-4

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