The efficacy and safety analysis of transarterial embolization in the treatment of cystic neuroendocrine neoplasm liver metastasis

doi:10.19401/j.cnki.1007-3639.2022.09.006

Abstract

Abstract:

Background and Purpose: Liver metastases are common in neuroendocrine neoplasm (NEN). Cystic NEN liver metastases (cNENLM) are rare, and the efficacy of transarterial embolization (TAE) has not been reported. This study summarized and analyzed the efficacy and safety of TAE for cNENLM. Methods: From January 2016 to April 2022, 10 patients with cNENLM were enrolled in this study among 440 patients under TAE treatment at The First Affiliated Hospital, Sun Yat-sen University and Fudan University Shanghai Cancer center. The efficacy was evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. Objective response rate (ORR), disease control rate (DCR) and progression-free survival (PFS) were analyzed as well. The common terminology criteria for adverse events (CTCAE) v5.0 was applied to evaluate the adverse effects. Results: With 80.0% ORR and 100.0% DCR according to RECIST 1.1, 3 cases achieved PFS. Among them, the longest one was 25.0 months. Disease progression was not observed in the remaining patients. The common complications were fever, hepatalgia and transient liver dysfunction, which could be alleviated by symptomatic treatment. No severe complication occurred. Conclusion: cNENLM are infrequent. TAE had significant curative effect on cNENLM, and complications were manageable.

Key words: Transaterial embolization, Neuroendocrine neoplasm, Liver metastasis, Cystic, Efficacy, Safety

CLC Number:

R735.7

YU Hang, LIU Wensheng, ZHANG Ning, LIU Haikuan, CHEN Luohai, YAO Wang, FAN Wenzhe, LI Jiaping, CHEN Jie, WANG Yu. The efficacy and safety analysis of transarterial embolization in the treatment of cystic neuroendocrine neoplasm liver metastasis[J]. China Oncology, 2022, 32(9): 794-799.

Figures/Tables 5

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Case	1	2	3	4	5	6	7	8	9	10
Age/year	56	62	57	59	39	52	57	54	52	47
Gender	Male	Male	Female	Female	Female	Male	Female	Male	Male	Female
Primary site	Rectum	Rectum	Stomach	Rectum	Pancreas	Retroperitoneum	Pancreas	Pelvic cavity	Testis	Kidney
Tumor grade	2	1	2	2	2	2	3	2	2	2
Ki-67 proliferation index/%	8	2	3	3	8	5	25	25	15	20
Extrahepatic metastasis	None	Bone, lymph node, kidney	Lymph node	Lymph node	Lymph node, peritoneum, mesentery, omentum	Bone, lymph node, lung	None	Sacrum	None	Bone
System therapy	SSA	SSA	SSA	SSA	SSA	CAPTEM	SSA	SSA	SSA	SSA
Response	PR	PR	PR	SD	PR	SD	PR	PR	PR	PR
PFS/month	12.4	NA	NA	11.7	25.0	NA	NA	NA	NA	NA
Resection	NA	NA	NA	NA	NA	NA	Pancreas	NA	Testis	Kidney
Tumor burden	10%-25%	10%-25%	25%-50%	10%-25%	>50%	>50%	10%-25%	>50%	10%-25%	>50%
Maximum diameter/mm	42.8	97.4	55.1	21.3	80.9	162.0	32.0	79.0	49.0	140.0

Item	G1	G2
Fever	3 (30.0)	0 (0.0)
Nausea and vomiting	6 (60.0)	0 (0.0)
Abdominal pain	8 (80.0)	1 (10.0)
Elevated liver enzymes	9 (90.0)	0 (0.0)