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Transarterial embolization (TAE) is equally effective and slightly safer than transarterial chemoembolization (TACE) to manage liver metastases in neuroendocrine tumors

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Abstract

Liver metastases from neuroendocrine tumor (NET) can be treated by transarterial embolization (TAE) or transarterial chemoembolization (TACE). The goal of TAE and TACE is to reduce blood flow to the tumor resulting in tumor ischemia and necrosis. In this retrospective study, the effectiveness and safety of TAE–TACE in the treatment of liver metastases in patients with NET was compared. Thirty patients with a histologically confirmed gastro-entero-pancreatic NET with liver metastases were retrospectively investigated. Seventeen patients underwent TAE, while 13 patients underwent TACE. Tumor response, degree of devascularization in treated lesions, and progression free survival (PFS) were evaluated in the whole population and then separately in TAE and TACE subgroups. In all patients treated with TAE and TACE, there was a significant size reduction of lesions as compared to baseline. Per lesion reduction was 2.2 ± 1.4 versus 3.3 ± 1.5 cm for TAE (p < 0.001) and 2.2 ± 1.5 versus 3.4 ± 1.7 cm for TACE (p < 0.001). In the whole population, the median PFS for all patients was 36 months (16.2–55.7 CI), without significant difference between TAE and TACE. In no patient did adverse events grade 3 and 4 as well as TAE/TACE-related death occurred, while the post-embolization syndrome occurred in 41 % of patients treated with TAE and 61 % of those treated with TACE. TAE and TACE are both effective in NET patients with liver metastases. TAE should be preferred to TACE in light of its similar anti-tumor effects and slightly better toxicity profile.

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Abbreviations

NET:

Neuroendocrine tumor

TAE:

Transarterial embolization

TACE:

Transarterial chemoembolization

HPF:

High power fields

MDCT:

Contrast-enhanced multidetector-row computed tomography

PFS:

Progression free survival

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Acknowledgments

This study did not receive any specific Grant from any funding agency in the public, commercial or not-for-profit sector. We are extremely grateful to all subjects who took part in these studies and the research teams who collected the data. All the authors contributed equally to the preparation of this article.

Conflict of interest

All the authors declare that there are no conflict of interest that could be perceived as prejudicing the impartiality of the data reported.

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Authors and Affiliations

  1. Interventional Radiology, National Cancer Institute, Fondazione “G. Pascale”, Naples, Italy

    Francesco Fiore

  2. Department of Clinical Medicine and Surgery, University Federico II of Naples, Via Pansini 5, 80131, Naples, Italy

    Michela Del Prete, Vincenzo Marotta, Valeria Ramundo, Francesca Marciello, Anna Chiara Carratù, Chiara de Luca di Roseto, Annamaria Colao & Antongiulio Faggiano

  3. Pathology Department, National Cancer Institute, Fondazione “G. Pascale”, Naples, Italy

    Renato Franco

  4. Interventional Unit Ultrasound, A.O. Dei Colli, Naples, Italy

    Antonella Di Sarno

  5. Department of Endocrinology, National Cancer Institute, Fondazione “G. Pascale”, Naples, Italy

    Antongiulio Faggiano

Authors
  1. Francesco Fiore
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  2. Michela Del Prete
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  3. Renato Franco
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  4. Vincenzo Marotta
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  5. Valeria Ramundo
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  6. Francesca Marciello
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  7. Antonella Di Sarno
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  8. Anna Chiara Carratù
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  9. Chiara de Luca di Roseto
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  10. Annamaria Colao
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  11. Antongiulio Faggiano
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Corresponding author

Correspondence to Michela Del Prete.

Additional information

On the behalf of the Multidisciplinary Group for NeuroEndocrine Tumors of Naples.

Francesco Fiore and Michela Del Prete contributed equally to the paper.

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Fiore, F., Del Prete, M., Franco, R. et al. Transarterial embolization (TAE) is equally effective and slightly safer than transarterial chemoembolization (TACE) to manage liver metastases in neuroendocrine tumors. Endocrine 47, 177–182 (2014). https://doi.org/10.1007/s12020-013-0130-9

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  • DOI: https://doi.org/10.1007/s12020-013-0130-9

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