Hepatic metastases from medullary thyroid carcinoma (MTC) may impair quality of life by hypercalcitonemia-associated diarrhea and pain. In this prospective study, the effect of selective arterial chemoembolization (SACE) was evaluated.
Eleven patients with hepatic metastases from MTC received 1 to 9 courses of SACE using epirubicine. Symptomatic, biochemical, and morphologic responses on SACE were recorded.
Symptomatic response was observed in all symptomatic patients. However, biochemical and radiologic response occurred only in 6 patients. Liver function was not affected by SACE. One patient with unexpected concurrent pheochromocytoma metastases died after the first course. Development of side effects in the course was observed in 8 patients but were only World Health Organization grade 1. Patients' satisfaction with SACE was excellent. Long-term follow-up found 7 patients alive (1-72 months). Three patients died with tumor 6, 12, and 24 months after SACE, respectively.
SACE provided good symptom palliation for the majority of patients with hepatic metastases from MTC. However, transient remission or stabilization of hepatic metastases resulted in only 60%. Further studies using a randomized protocol are required.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Hepatic metastases in medullary thyroid carcinoma: possible pitfall with MR imaging.Eur J Radiol. 1990; 11: 107-109
- Laparoscopic detection of hepatic metastases in patients with residual or recurrent medullary thyroid cancer.Surgery. 1995; 118: 1024-1030
- Angiography effectively supports the diagnosis of hepatic metastases in medullary thyroid carcinoma.Cancer. 2001; 91: 2084-2095
- Angiography-proven liver metastases explain low efficacy of lymph node dissections in medullary thyroid cancer patients.Eur J Surg Oncol. 2005; 31: 183-190
- Advances in the management of hereditary medullary thyroid cancer.J Int Med. 2005; 257: 50-59
- High frequency of bone/bone marrow involvement in advanced medullary thyroid cancer.JC Endocrinol Metab. 2005; 90: 779-788
- Prospects of remission in MTC according to basal calcitonin level.J Clin Metabol. 2005; 90: 1-6
- Calcitonin kinetics in the early postoperative period of medullary thyroid carcinoma.Langenbeck`s Arch Surg. 2001; 386: 434-439
- Long-term course of patients with peristent hypercalcitonemia after apparent curative primary surgery for medullary thyroid carcinoma.Ann Surg. 1990; 212: 395-401
- Treatment of advanced medullary thyroid cancer with an alternative combination of doxorubicin-streptozocin and 5 FU-dacarbazine.Br J Cancer. 2000; 83: 715-718
- Hepatic arterial chemoembolization in patients with liver metastases of endocrine tumors.Cancer. 1993; 71: 2624-2630
- Systematic review of randomized trials for unresectable hepatocellular carcinoma: chemoembolization improves survival.Hepatology. 2003; 37: 429-442
- Transarterial chemoembolization of advanced liver metastases of neuroendocrine tumors—a retrospective single-center experience.Digestion. 2003; 9: 94-101
- Intra-arterial hepatic chemoembolization in liver metastases from neuroendocrine tumors: a phase II study.J Chemother. 2004; 16: 293-297
- Hepatic artery embolization and chemoembolization for treatment of patients with metastatic carcinoid tumors: the M.D. Anderson experience.Cancer J. 2003; 9: 261-267
- Chemoembolization of liver metastases from medullary thyroid carcinoma.Ann Intern Med. 2000; 132: 596-597
- Improved prediction of calcitonin normalization in MTC patients by quantitative lymph node analysis.Cancer. 2000; 88: 1909-1915
- Medullary thyroid cancer: multivariate analyses of prognostic factors influencing survival.Eur J Surg Oncol. 2000; 26: 686-690
- Long-term results of reoperation and localizing studies in patients with persistent or recurrent medullary thyroid cancer.Arch Surg. 2000; 135: 895-901
- Progression of postoperative residual medullary thyroid carcinoma as monitored by plasma calcitonin levels.Surgery. 1996; 119: 34-39
- Tumor response and clinical benefit in neuroendocrine tumors after 7.4 Gbq 90Y-DOTATOC.J Nucl Med. 2002; 43: 610-616
- Clinical results of peptide receptor radionuclide therapy (PRRT) with yttrium-90-DOTA-TYR3-OCTREOTATE (Y-90-DOTA-TATE) in patients with neuroendocrine tumors.J Nucl Med. 2004; 45: 90-99
Accepted: September 22, 2005Halle, Germany
© 2005 Mosby, Inc. Published by Elsevier Inc. All rights reserved.