Particle embolization of hepatic neuroendocrine metastases for control of pain and hormonal symptoms

PURPOSE: To evaluate treatment outcome with respect to the indication for t reatment in patients with neuroendocrine tumors metastatic to the liver und ergoing hepatic artery embolization with polyvinyl alcohol (WA) particles. MATERIALS AND METHODS: Charts and radiographs were reviewed of 35 patients undergoing 63 separate sessions of embolotherapy between January 1993 and J uly 1997, Patient demographics, tumor type, indication for embolization, an d complications were recorded. Symptomatic and morphologic responses to the rapy were noted, as well as duration of response, RESULTS: Fourteen men and 21 women underwent embolization of 21 carcinoid a nd 14 islet cell tumors metastatic to the liver. These patients underwent 6 3 separate episodes of embolotherapy, Of 48 episodes that could be evaluate d, response to treatment was noted following 46 episodes (96%). The duratio n of response was longest in patients treated for hormonal symptoms with (1 7.5 months) or without (16 months) pain, and was shortest (6.2 months) when the indication was pain alone. Complications occurred after 11 of the 63 e mbolizations (17%), including four (6%) deaths. Cumulative 5-year survival following embolotherapy was 54%. CONCLUSION: Hepatic artery embolization with PVA particles is beneficial fo r patients with neuroendocrine tumors metastatic to the liver and may be us ed for control of pain as well as hormonal symptoms. This therapy should be used cautiously when more than 75% of the hepatic parenchyma is replaced b y tumor.