Hepatic Artery Chemoembolization in 122 Patients with Metastatic Carcinoid Tumor: Lessons Learned

Bloomston, Mark; Al-Saif, Osama; Klemanski, Dori; Pinzone, Joseph J.; Martin, Edward W.; Palmer, Bryan; G, Guy; Khabiri, Hooman; Ellison, E. Christopher; Shah, Manisha H.

doi:10.1007/s11605-007-0089-z

Cited by 106 publications

(76 citation statements)

References 29 publications

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“…Thus, in a trial of 122 patients with metastatic net who underwent hepatic artery embolization, 82% experienced tumour regression and 12% experienced stable disease, with a median response duration of 19 months 46 . The effectiveness of radiofrequency ablation was suggested by recent trial in 148 patients with unresectable metastatic liver nets 47 .…”

Section: Summary Of Evidencementioning

confidence: 99%

Eastern Canadian Gastrointestinal Cancer Consensus Conference 2014

et al. 2015

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The annual Eastern Canadian Colorectal Cancer Consensus Conference was held in Montreal, Quebec, 23-25 October 2014. Expert radiation, medical, and surgical oncologists and pathologists involved in the management of patients with gastrointestinal malignancies participated in presentations and discussions resulting in consensus statements on such hot topics as management of neuroendocrine tumours, advanced and metastatic pancreatic cancer, and metastatic colorectal cancer.

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Section: Summary Of Evidencementioning

confidence: 99%

Eastern Canadian Gastrointestinal Cancer Consensus Conference 2014

et al. 2015

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“…Liver metastases suitable for resection can be operated for curative therapy. Radiofrequency ablation, transcatheter arterial chemo-embolization, or intraarterial chemotherapy may be performed in patients in whom curative surgery is not an option (3,10). In the last 25 years, successful liver transplantation has been reported for patients with liver metastases of neuroendocrine tumors (2,4,7,10).…”

Section: Discussionmentioning

confidence: 99%

Metastasis of carcinoid tumor to the transplanted liver graft: A rare case report

Akbulut

Yılmaz²,

Arabaci³

et al. 2014

Turk J Gastroenterol

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In this study, we present a rare case of gastrointestinal carcinoid tumor that metastasized to a transplanted liver graft. A 14-year-old female patient suffering from cryptogenic cirrhosis had undergone liver transplantation. The liver was received from a deceased donor. She presented to our clinic with complaints of abdominal pain, diarrhea, flushing, fatigue, and syncope four years after transplantation. On multislice computed tomography, multiple masses ranging from 1 cm to 4 cm in size were detected in both lobes of the transplanted liver. Biopsy from both lobes revealed carcinoid tumor. The primary tumor could not be localized, and a colonoscopy was scheduled. As the patient refused an invasive investigation, octreotide therapy was begun. Her symptoms related to the carcinoid tumor diminished following initiation of the octreotide therapy. During the fifth year of octreotide therapy, a wholebody positron emission tomography (PET CT) with 10 mCi F-18 fludeoxyglucose (FDG) showed an increase in the metabolic activity with a SUVmax value of 8 at the localization site, consistent with the ileocecal region. The findings were considered secondary, as the carcinoid tumor originated from the appendix or distal ileum. Again, the patient again refused endoscopic investigations and continued the follow-up visits. To our knowledge, this is the only reported case in the scientific literature of a carcinoid tumor that metastasized to a transplanted liver.

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“…Response on the secretory syndrome is obtained in 52-86% of cases with a duration of response often longer than 12 months (30,32).…”

Section: Chemoembolization and Embolizationmentioning

confidence: 99%

GEP-NETS UPDATE: Interventional radiology: role in the treatment of liver metastases from GEP-NETs

Baère

Deschamps

Tselikas

et al. 2015

European Journal of Endocrinology

110

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Neuroendocrine tumors from gastro-pancreatic origin (GEP-NET) can be responsible for liver metastases. Such metastases can be the dominant part of the disease as well due to the tumor burden itself or the symptoms related to such liver metastases. Intra-arterial therapies are commonly used in liver only or liver-dominant disease and encompass trans-arterial chemoembolization (TACE), trans-arterial embolization (TAE), and radioembolization (RE). TACE performed with drug emulsified in Lipiodol has been used for the past 20 years with reported overall survival in the range of 3-4 years, with objective response up to 75%. Response to TACE is higher when treatment is used as a first-line therapy and degree of liver involvement is lower. Benefit of TACE over TAE is unproven in randomized study, but reported in retrospective studies namely in pancreatic NETs. RE provides early interesting results that need to be further evaluated in terms of benefit and toxicity. Radiofrequency ablation allows control of small size and numbered liver metastases, with low invasiveness. Ideal metastases to target are one metastasis !5 cm, or three metastases !3 cm, or a sum of diameter of all metastases below 8 cm. Ablation therapies can be applied in the lung or in the bones when needed, and more invasive surgery should be probably saved for large-size metastases. Even if the indication of image-guided therapy in the treatment of GEP-NET liver metastases needs to be refined, such therapies allow for manageable invasive set of treatments able to address oligometastatic patients in liver, lung, and bones. These treatments applied locally will save the benefit and the toxicity of systemic therapy for more advanced stage of the disease.

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Hepatic Artery Chemoembolization in 122 Patients with Metastatic Carcinoid Tumor: Lessons Learned

Cited by 106 publications

References 29 publications

Eastern Canadian Gastrointestinal Cancer Consensus Conference 2014

Eastern Canadian Gastrointestinal Cancer Consensus Conference 2014

Metastasis of carcinoid tumor to the transplanted liver graft: A rare case report

GEP-NETS UPDATE: Interventional radiology: role in the treatment of liver metastases from GEP-NETs

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