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Article

Long Term Efficacy and Assessment of Tumor Response of Transarterial Chemoembolization in Neuroendocrine Liver Metastases: A 15-Year Monocentric Experience

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Gustave Roussy, Département d’Anesthésie, Chirurgie et Interventionnel (DACI), F-94805 Villejuif, France
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INSERM U1018 OncoStat, CESP, Universtié Paris-Sud, F-94805 Villejuif, France
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Gustave Roussy, Cancer Medicine Department, F-94805 Villejuif, France
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Beaujon Hospital, Department of Radiology, Université de Paris, APHP.Nord, F-92110 Clichy, France
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MD Anderson Cancer Center, Medical Imaging Department, University of Texas, Houston, TX 77030, USA
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Gustave Roussy, Medical Imaging Department, F-94805 Villejuif, France
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Gustave Roussy, Department of Medical Biology and Pathology, F-94805 Villejuif, France
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Faculty of Medicine, Paris-Saclay University, F-94276 Le Kremlin Bicêtre, France
*
Author to whom correspondence should be addressed.
Academic Editor: Guido Rindi
Cancers 2021, 13(21), 5366; https://doi.org/10.3390/cancers13215366
Received: 11 September 2021 / Revised: 15 October 2021 / Accepted: 15 October 2021 / Published: 26 October 2021
(This article belongs to the Special Issue Advances in Diagnostic and Interventional Radiology in Oncology)
Neuroendocrine tumors (NET) are rare tumors, with long-term survival even for patients with liver metastases. Transarterial chemoembolization (TACE) is one of the most widely used treatments in this setting. The aim of the study was to assess the long-term efficacy of TACE in a large cohort of patients with NET liver metastases and to correlate imaging findings with survival. In our study including 202 patients with NET liver metastases and a mean follow-up of 8.2 years, TACE was effective to provide disease control for 26 months and a 5.3-year median overall survival (OS). Imaging responses using RECIST and mRECIST criteria were significantly correlated to OS: the median-OS was twice as long among mRECIST responders versus non-responders, with 80.5 months and 39.6 months respectively. These findings are of major importance for everyday practice as they confirm TACE’s effectiveness and usefulness of imaging evaluation to better tailor patient treatment and repeat TACE sessions whenever necessary.
Background: transarterial chemoembolization (TACE) is an established treatment for neuroendocrine tumor (NET) liver metastases. The aim was to evaluate the long-term treatment efficacy of TACE for NET liver metastases, and correlate imaging response with survival. Methods: this IRB-approved, single-center, retrospective study evaluated all TACE procedures performed for NET liver metastases from 2003–2017 for imaging tumor response (RECIST and mRECIST), time to liver progression (TTLP), time to untreatable progression with TACE (TTUP), and overall survival (OS). Patient, tumor, and treatment characteristics were analyzed as prognostic factors. Survival curves according to the Kaplan–Meier method were compared by Log-rank test. Tumor responses according to RECIST and mRECIST were correlated with OS. Results: 555 TACE procedures were performed in 202 NET patients (38% grade 1, 60% grade 2) with primary tumors originating from pancreas, small bowel, and lung (39, 26, and 22% respectively). Median follow-up was 8.2 years (90–139 months). Median TTLP and TTUP were 19.3 months (95%CI 16.3–22.3) and 26.2 months (95%CI 22.3–33.1), respectively. Median OS was 5.3 years (95%CI 4.2–6.7), and was higher among mRECIST responders (80.5 months; 95%CI 64.6–89.8) than in non-responders (39.6 months; 95%CI = 32.8–60.2; p < 0.001). In multivariable analysis, age, tumor grade and liver involvement predicted worse OS, whereas administration of somatostatin analogs correlated with improved OS. Conclusion: TACE for NET liver metastases provides objective response and sustained local disease control rates. RECIST and mRECIST responses correlate with OS. View Full-Text
Keywords: neuroendocrine neoplasms; chemoembolization; intra-arterial therapies; RECIST; mRECIST; liver metastases neuroendocrine neoplasms; chemoembolization; intra-arterial therapies; RECIST; mRECIST; liver metastases
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MDPI and ACS Style

Touloupas, C.; Faron, M.; Hadoux, J.; Deschamps, F.; Roux, C.; Ronot, M.; Yevich, S.; Joskin, J.; Gelli, M.; Barbé, R.; Lamartina, L.; Tissot, H.; Scoazec, J.-Y.; Malka, D.; Ducreux, M.; Baudin, E.; de Baère, T.; Tselikas, L. Long Term Efficacy and Assessment of Tumor Response of Transarterial Chemoembolization in Neuroendocrine Liver Metastases: A 15-Year Monocentric Experience. Cancers 2021, 13, 5366. https://doi.org/10.3390/cancers13215366

AMA Style

Touloupas C, Faron M, Hadoux J, Deschamps F, Roux C, Ronot M, Yevich S, Joskin J, Gelli M, Barbé R, Lamartina L, Tissot H, Scoazec J-Y, Malka D, Ducreux M, Baudin E, de Baère T, Tselikas L. Long Term Efficacy and Assessment of Tumor Response of Transarterial Chemoembolization in Neuroendocrine Liver Metastases: A 15-Year Monocentric Experience. Cancers. 2021; 13(21):5366. https://doi.org/10.3390/cancers13215366

Chicago/Turabian Style

Touloupas, Caroline, Matthieu Faron, Julien Hadoux, Frédéric Deschamps, Charles Roux, Maxime Ronot, Steven Yevich, Julien Joskin, Maximiliano Gelli, Rémy Barbé, Livia Lamartina, Hubert Tissot, Jean-Yves Scoazec, David Malka, Michel Ducreux, Eric Baudin, Thierry de Baère, and Lambros Tselikas. 2021. "Long Term Efficacy and Assessment of Tumor Response of Transarterial Chemoembolization in Neuroendocrine Liver Metastases: A 15-Year Monocentric Experience" Cancers 13, no. 21: 5366. https://doi.org/10.3390/cancers13215366

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