Transcatheter therapy of gastric cancer metastatic to the liver: preliminary results

Abstract

Little is known about the effectiveness of transcatheter chemotherapy in liver metastases from gastric cancer. The aim of this study was to evaluate the initial results of hepatic artery infusion and oily chemoembolization in these liver secondaries. Courses of transcatheter arterial infusion with 5-fluorouracil/ doxorubicin (12 patients) and oily chemoembolization with doxorubicin-in-iodized oil and gelatin sponge (12 patients) were performed in 24 patients with histologically proven unresectable gastric cancer liver metastases. A positive effect of treatment (partial response + stabilization) was seen in 92% of the patients after chemoinfusion and in 50% after chemoembolization. The 1- and 2-year actuarial survival rates were 92% and 53% for infusion vs 50% and 17% for chemoembolization, respectively (log-rank test, P = 0.0009). For patients who had already died, the mean survival was 19.2 months vs 9.5 months (Student's t-test, P < 0.05) with median survivals of 23 months vs 8 months, respectively. The results with arterial infusion were very close to those reported for liver resection. Transcatheter therapy appears to be useful for the palliation of unresectable liver metastases from gastric cancer. If regional chemotherapy is used, arterial infusion should be the first-choice treatment, with oily chemoembolization being reserved for patients who do not respond to infusion.

Colorectal liver metastases: regional chemotherapy via transarterial chemoembolization (TACE) and hepatic chemoperfusion: an update

“…Also, embolization is useful in the presence of an associated vascular lesion as an AV malformation, fistula, or a hemangioma. HAI, TAE and TACE have shown promising symptomatic, morphological and survival results in liver metastases from other primary tumours, like malignant melanoma, neuroendocrine and carcinoid tumours, breast and gastric cancer [22,23,28,29,[33][34][35][36][37][38][39][40][41].…”

Neoadjuvant TACE before laser induced thermotherapy (LITT) in the treatment of non-colorectal non-breast cancer liver metastases: Feasibility and survival rates

“…The use of TACE and laser induced ablation as treatment for non-colorectal and non-breast cancer liver metastases in our patients showed a mean survival of 40.8 months. Whereas in studies dealing with the use of TACE alone in similar patient groups showed lower survival times (5-21 months), with extended survival of up to 60 months in studies concerning only neuroendocrine primaries [10,20,23]. Results for the use of ablative techniques alone in the treatment of liver metastases have shown survival times of up to 48 months in patients treated with LITT and up to 37 months for radiofrequency ablation.…”

“…Still it is important to notice that the current treatment regimen should not be regarded as an alternative to surgery and should be reserved only to unresectable patients not responding to systemic chemotherapy. Untreated patients present with a median survival of 2-8 months [6,20,21]. Furthermore, TACE treatments induce a high local concentration of chemotherapeutic agents with a lower systemic toxicity than systemic chemotherapy regimes.…”

Serial pancreas, liver and duodenal metastasis from renal clear cell cancer: a case report

“…Secondary liver metastasis was then diagnosed by integral analysis of the disease history, laboratory findings and abdominal CT imaging. Although surgical resection remains as a curative treatment for hepatic metastastic cancer, transcatheter arterial chemoembolization (TACE) has become an effective option for those unresectable liver metastases from pancreatic carcinoid tumor, gastric, colorectal, or breast cancers [13][14][15][16] . In view of the rich blood supply of liver metastatic carcinomas as well as the poor condition in this aged patient, a selective TACE was performed to prolong survival.…”