Control of carcinoid syndrome with hepatic artery embolization.

Abstract

Eighteen patients with metastatic carcinoid were treated by hepatic artery embolization with Gelfoam or polyvinyl alcohol foam for control of the carcinoid syndrome. Seventeen showed subjective or objective clinical improvement, including less skin flushing, diarrhea, and bronchospasm. Fourteen showed improvement in biochemical indices, including decreased urinary 5-hydroxyindoleacetic acid levels. The mean life span of the treated patients from the first episode of flushing to the time of this report was 5.4 years, and half of the patients are still alive. This survival time compares favorably with previous reports of survival of 3.2 years from the onset of flushing.

Transarterial Chemoembolization of Advanced Liver Metastases of Neuroendocrine Tumors – A Retrospective Single-Center Analysis

“…Six patients are still alive, 1 was lost to follow-up. This is in concordance with other studies reporting median survival times of 64 months and 5-year survival times of 52% [20]. The presence of a non-resectable primary tumor had no effect on the average survival time in our cohort.…”

Consensus Guidelines for the Management of Patients with Liver Metastases from Digestive (Neuro)endocrine Tumors: Foregut, Midgut, Hindgut, and Unknown Primary

“…The procedure can be performed repeatedly. Median survival in patients treated with TAE is between 59 and 64 months after the occurrence of the first symptoms of the carcinoid syndrome [97] . In two recent series using TACE, overall survival rates at 5 years were 83 and 50%, respectively [96,97] .…”

“…Median survival in patients treated with TAE is between 59 and 64 months after the occurrence of the first symptoms of the carcinoid syndrome [97] . In two recent series using TACE, overall survival rates at 5 years were 83 and 50%, respectively [96,97] . For TACE, the cytotoxic agent most often used is doxorubicin [98][99][100][101][102][103][104] or streptozotocin.…”

Interventional Treatment of the Carcinoid Syndrome

“…In the early series (n = 63) of Coupe et al [20]in patients with advanced disease, half of the patients were embolized without survival advantage, while others have reported prolongation of expected survival with a few years [21]. A survival advantage for embolized patients was indicated in one small randomized study using surgery and interferon as common treatment [22].…”