Repetitive transarterial chemoembolization (TACE) of liver metastases from gastric cancer: local control and survival results.

Abstract

OBJECTIVE:

To evaluate the local tumor control and survival data after transarterial chemoembolization with different drug combinations in the palliative treatment of patients with liver metastases of gastric cancer.

MATERIALS AND METHODS:

The study was retrospectively performed. 56 patients (mean age, 52.4) with unresectable liver metastases of gastric cancer who did not respond to systemic chemotherapy were repeatedly treated with TACE in 4-week intervals. In total, 310 chemoembolization procedures were performed (mean, 5.5 sessions per patient). The local chemotherapy protocol consisted of mitomycin alone (30.4%), mitomycin and gemcitabine (33.9%), or mitomycin, gemcitabine and cisplatin (35.7%). Embolization was performed with lipiodol and starch microspheres. Local tumor response was evaluated by MRI according to RECIST. Survival data from first chemoembolization were calculated according to the Kaplan-Meier method.

RESULTS:

The local tumor control was: complete response in 1.8% (n=1), partial response in 1.8% (n=1), stable disease in 51.8% (n=29) and progressive disease in 44.6% (n=25) of patients. The 1-, 2-, and 3-year survival rate from the start of chemoembolization were 58%, 38%, and 23% respectively. The median and mean survival times were 13 and 27.1 months. A Statistically significant difference between patients treated with different chemotherapy protocols was noted (ρ=0.045) with the best survival time in the mitomycin, gemcitabine and cisplatin group.

CONCLUSION:

Transarterial chemoembolization is a minimally invasive therapy option for palliative treatment of liver metastases in patients with gastric cancer.

• Authors: Thomas J Vogl, Tatjana Gruber-Rouh, Katrin Eichler, Nour-Eldin A Nour-Eldin, Jörg Trojan, Stephan Zangos, Nagy N N Naguib
• Journal: European journal of radiology (Eur J Radiol) Vol. 82 Issue 2 Pg. 258-63 (Feb 2013) ISSN: 1872-7727 [Electronic] Ireland
• PMID: 23127803 (Publication Type: Journal Article)
• Copyright: Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage)
• Chemoembolization, Therapeutic (mortality)
• Disease-Free Survival
• Female
• Germany (epidemiology)
• Humans
• Liver Neoplasms (mortality, secondary, therapy)
• Male
• Middle Aged
• Neoplasm Recurrence, Local (mortality, prevention & control)
• Prevalence
• Retrospective Studies
• Stomach Neoplasms (mortality, therapy)
• Survival Analysis
• Survival Rate
• Treatment Outcome