Transarterial chemoembolization is ineffective for neuroendocrine tumors metastatic to the caudate lobe: a single institution review.

Authors

Lawrence A Shirley, Division of Surgical Oncology, The Ohio State University Wexner Medical CenterFollow
Megan McNally, Department of Surgery, Saint Luke's Health System and University of Missouri-Kansas City
Ravi Chokshi, Division of Surgical Oncology, Rutgers University-New Jersey Medical School
Natalie Jones, Riverside Methodist Hospital, Department of Surgery
Patrick Tassone, Department of Otolaryngology, Thomas Jefferson University HospitalFollow
Gregory Guy, Department of Radiology, The Ohio State University Wexner Medical Center
Hooman Khabiri, Department of Radiology, The Ohio State University Wexner Medical Center
Carl Schmidt, Division of Surgical Oncology, The Ohio State University Wexner Medical Center
Manisha Shah, Division of Medical Oncology, The Ohio State University Wexner Medical Center
Mark Bloomston, Division of Surgical Oncology, The Ohio State University Wexner Medical Center

Document Type

Article

Publication Date

5-1-2015

Comments

This article has been peer reviewed. It was published in: World Journal of Surgical Oncology.

Volume 13, Issue 1, May 01, 2015, Article number 167.

The published version is available at DOI: 10.1186/s12957-015-0551-4

Copyright © Shirley et al.; licensee BioMed Central.

Abstract

BACKGROUND: Caudate lobe liver metastases occur commonly in patients with neuroendocrine tumors. It is unknown, however, how these lesions respond to regional therapy and how their presence impacts outcomes. We reviewed our experience treating these lesions using transarterial chemoembolization (TACE).

METHODS: We reviewed radiographic response to TACE in 86 patients with metastatic neuroendocrine tumors to the liver. We determined the impact of caudate lesions on outcomes in comparison to the cohort of patients without caudate lesions, as well as response of caudate lesions to TACE versus lesions elsewhere in the liver.

RESULTS: Caudate lesions were identified in 45 (52%) patients. All patients had disease in other liver segments. Only seven caudate lesions (12.3%) had a radiographic response to TACE, whereas 82% of lesions elsewhere in the liver demonstrated a response. The presence or absence of a caudate lesion did not impact the overall radiographic (82.2% vs. 82.9%), symptomatic (64.4% vs. 56.1%), or biochemical (97.6% vs. 88.9%) response to TACE (P > 0.1 for all). However, median overall survival was reduced in those presenting with caudate lesions (87.1 vs. 45.6 months, P = 0.031).

CONCLUSIONS: Metastatic neuroendocrine tumors to the caudate lobe respond poorly to TACE. Symptomatic or threatening caudate lobe lesions should be considered for palliative resection in spite of additional inoperable liver metastases.

Recommended Citation

Shirley, Lawrence A; McNally, Megan; Chokshi, Ravi; Jones, Natalie; Tassone, Patrick; Guy, Gregory; Khabiri, Hooman; Schmidt, Carl; Shah, Manisha; and Bloomston, Mark, "Transarterial chemoembolization is ineffective for neuroendocrine tumors metastatic to the caudate lobe: a single institution review." (2015). Department of Otolaryngology - Head and Neck Surgery Faculty Papers. Paper 30.
https://jdc.jefferson.edu/otofp/30

PubMed ID

25927667