Outcomes of repeat conventional transarterial chemoembolization in patients with liver metastases

Kamyar Ghabili; Austin-Marley Windham-Herman; Menelaos Konstantinidis; Nikitha Murali; Tabea Borde; Lucas C. Adam; Fabian Laage-Gaupp; MingDe Lin; Julius Chapiro; Christos Georgiades; Nariman Nezami

Annals of Hepatology (Nov 2024)

Outcomes of repeat conventional transarterial chemoembolization in patients with liver metastases

Kamyar Ghabili,
Austin-Marley Windham-Herman,
Menelaos Konstantinidis,
Nikitha Murali,
Tabea Borde,
Lucas C. Adam,
Fabian Laage-Gaupp,
MingDe Lin,
Julius Chapiro,
Christos Georgiades,
Nariman Nezami

Affiliations

Kamyar Ghabili: Department of Radiology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA; Section of Vascular and Interventional Radiology, Department of Radiology and Biomedical imaging, Yale University School of Medicine, New Haven, Connecticut, USA
Austin-Marley Windham-Herman: Section of Vascular and Interventional Radiology, Department of Radiology and Biomedical imaging, Yale University School of Medicine, New Haven, Connecticut, USA; Department of Interventional Radiology, University of California San Diego, La Jolla, California, USA
Menelaos Konstantinidis: Institute of Health Policy, Management and Evaluation, University of Toronto, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Canada
Nikitha Murali: Section of Vascular and Interventional Radiology, Department of Radiology and Biomedical imaging, Yale University School of Medicine, New Haven, Connecticut, USA; Section of Interventional Radiology, Department of Radiology, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
Tabea Borde: Section of Vascular and Interventional Radiology, Department of Radiology and Biomedical imaging, Yale University School of Medicine, New Haven, Connecticut, USA; Department of Neurology and Experimental Neurology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health, Charité Campus Benjamin Franklin (CBF), Berlin, Germany
Lucas C. Adam: Section of Vascular and Interventional Radiology, Department of Radiology and Biomedical imaging, Yale University School of Medicine, New Haven, Connecticut, USA; Department of Neurology and Experimental Neurology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health, Charité Campus Benjamin Franklin (CBF), Berlin, Germany
Fabian Laage-Gaupp: Section of Vascular and Interventional Radiology, Department of Radiology and Biomedical imaging, Yale University School of Medicine, New Haven, Connecticut, USA
MingDe Lin: Section of Vascular and Interventional Radiology, Department of Radiology and Biomedical imaging, Yale University School of Medicine, New Haven, Connecticut, USA
Julius Chapiro: Section of Vascular and Interventional Radiology, Department of Radiology and Biomedical imaging, Yale University School of Medicine, New Haven, Connecticut, USA
Christos Georgiades: Division of Vascular and Interventional Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
Nariman Nezami: Section of Vascular and Interventional Radiology, Department of Radiology and Biomedical imaging, Yale University School of Medicine, New Haven, Connecticut, USA; Division of Vascular and Interventional Radiology, Department of Radiology, Medstar Georgetown Hospital, Washington, DC, USA; Georgetown University School of Medicine, Washington, DC, USA; Lombardi Comprehensive Cancer Center, Washington, DC, USA; Corresponding author.

Journal volume & issue: Vol. 29, no. 6
p. 101529

Abstract

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Introduction and Objectives: Although unlimited sessions of conventional transarterial chemoembolization (cTACE) may be performed for liver metastases, there is no data indicating when treatment becomes ineffective. This study aimed to determine the optimal number of repeat cTACE sessions for nonresponding patients before abandoning cTACE in patients with liver metastases. Materials and Methods: In this retrospective, single-institutional analysis, patients with liver metastases from neuroendocrine tumors (NET), colorectal carcinoma (CRC), and lung cancer who underwent consecutive cTACE sessions from 2001 to 2015 were studied. Quantitative European Association for Study of the Liver (qEASL) criteria were utilized for response assessment. The association between the number of cTACE and 2-year, 5-year, and overall survival was evaluated to estimate the optimal number of cTACE for each survival outcome. Results: Eighty-five patients underwent a total of 186 cTACE sessions for 117 liver metastases, of which 30.7 % responded to the first cTACE. For the target lesions that did not respond to the first, second, and third cTACE sessions, response rates after the second, third, and fourth cTACE sessions were 33.3 %, 23 %, and 25 %, respectively. The fourth cTACE session was the optimal number for 2-year survival (HR 0.40; 95 %CI: 0.16–0.97; p = 0.04), 5-year survival (HR 0.31; 95 %CI: 0.11–0.87; p = 0.02), and overall survival (HR 0.35; 95 %CI: 0.13–0.89; p = 0.02). Conclusions: Repeat cTACE in the management of liver metastases from NET, CRC, and lung cancer was associated with improved patient survival. We recommend at least four cTACE sessions before switching to another treatment for nonresponding metastatic liver lesions.

Published in Annals of Hepatology

ISSN: 1665-2681 (Print); 2659-5982 (Online)
Publisher: Elsevier
Country of publisher: Spain
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine
Website: https://www.journals.elsevier.com/annals-of-hepatology

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