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Abstract
Background. Patients with neuroendocrine neoplasms, even with metastases to the liver, often
have indolent disease and are treated conservatively. However, when debilitating symptoms
from hormonal syndromes or mass effect arise, more aggressive treatment may be warranted.
Methods. Thirty-nine chemoembolization procedures were performed in 30 patients with significant
symptoms, with carcinoids and islet cell tumors. An emulsification of introarterial
doxorubicin, iodized oil, and water-soluble contrast was followed by embolization
with absorbable gelatin powder or pledgets.
Results. Twenty-seven patients exhibited subjective improvement in clinical symptoms. Hormonal
markers and/or tumor size decreased by at least 50% in 79% of patients. Inclusion
of minor responses raises this to 92%. Seven complications were noted, and no procedure-related
deaths occurred. Median survival was 24 months after chemoembolization or 53 months
after diagnosis. Computed tomographic features of tumor vascularity, distribution
of metastatic lesions, and distribution of ethiodized oil were not clearly correlated
with outcome. Presence of a nonresected primary tumor had a negative effect on survival.
Conclusions. Compared with previously described treatments for neuroendocrine liver metastases,
this technique appears to be more effective and to be associated with less morbidity,
and is recommended for patients with significant symptoms who have failed to respond
to more conservative therapy and who are not surgical candidates.
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Article info
Footnotes
☆Presented at the Fifteenth Annual Meeting of the American Association of Endocrine Surgeons, Dearborn, Mich., April 17–19, 1994.
Identification
Copyright
© 1994 Published by Elsevier Inc.
