BACKGROUND: Transarterial chemoembolization (TACE) is commonly used to treat metastatic carcinoid tumors; however, the management of progressive disease is less clear. We sought to determine if patients with disease progression after TACE would benefit from repeat TACE. METHODS: The records of 27 patients undergoing repeat TACE for radiologic or symptomatic progression after TACE for metastatic carcinoid were reviewed and compared to 122 undergoing first TACE. Overall and progression-free survivals were estimated by the Kaplan-Meier method. RESULTS: Mean disease-free interval after first TACE was 11.8 months. Radiologic response was observed in 61% compared to 82% after first TACE (p=0.058); hormone response in 64% compared to 80% (p=0.159); and symptomatic response in 77% compared to 92% (p=0.053). The complication rate after repeat TACE was lower than after first TACE (p=0.03). Median overall survival was similar after repeat (28.1 months) and first TACE (33.3 months) (p=0.53). Progression-free survival was shorter after repeat TACE but not significantly so. No factor examined could predict survival after repeat TACE. CONCLUSION: Repeat TACE for patients with hepatic carcinoid metastases failing first TACE or having evidence of disease progression is safe and offers a viable treatment option.
BACKGROUND: Transarterial chemoembolization (TACE) is commonly used to treat metastatic carcinoid tumors; however, the management of progressive disease is less clear. We sought to determine if patients with disease progression after TACE would benefit from repeat TACE. METHODS: The records of 27 patients undergoing repeat TACE for radiologic or symptomatic progression after TACE for metastatic carcinoid were reviewed and compared to 122 undergoing first TACE. Overall and progression-free survivals were estimated by the Kaplan-Meier method. RESULTS: Mean disease-free interval after first TACE was 11.8 months. Radiologic response was observed in 61% compared to 82% after first TACE (p=0.058); hormone response in 64% compared to 80% (p=0.159); and symptomatic response in 77% compared to 92% (p=0.053). The complication rate after repeat TACE was lower than after first TACE (p=0.03). Median overall survival was similar after repeat (28.1 months) and first TACE (33.3 months) (p=0.53). Progression-free survival was shorter after repeat TACE but not significantly so. No factor examined could predict survival after repeat TACE. CONCLUSION: Repeat TACE for patients with hepatic carcinoid metastases failing first TACE or having evidence of disease progression is safe and offers a viable treatment option.
Authors: R Arnold; M E Trautmann; W Creutzfeldt; R Benning; M Benning; C Neuhaus; R Jürgensen; K Stein; H Schäfer; C Bruns; H J Dennler Journal: Gut Date: 1996-03 Impact factor: 23.059
Authors: Sanjay Gupta; James C Yao; Kamran Ahrar; Michael J Wallace; Frank A Morello; David C Madoff; Ravi Murthy; Marshall E Hicks; Jaffer A Ajani Journal: Cancer J Date: 2003 Jul-Aug Impact factor: 3.360
Authors: Jill K Onesti; Lawrence A Shirley; Neil D Saunders; Gail W Davidson; Mary E Dillhoff; Hooman Khabiri; Gregory E Guy; Joshua D Dowell; Carl R Schmidt; Manisha H Shah; Mark Bloomston Journal: J Gastrointest Surg Date: 2015-10-21 Impact factor: 3.452