Arterial Chemoembolization in the Treatment of Carcinoid Liver Metastases Patients
An effectiveness of 190 transcatheter arterial chemoembolization (TACE) cycles in the treatment of 30 symptomatic unresectable carcinoid liver metastases patients is analyzed. Primary carcinoid tumor was resected in 17 and in 13 patients it was not diagnosed or not resected because of advanced stage. TACE was performed separately in each lobe using 30-60 mg doxorubicin-in-iodized oil with or without arterial occlusion with gelatin sponge. It was complicated with hormonal crisis in 8 patients and medical therapy was successful in all cases. One patient developed liver abscess, the latter was treated by percutaneous drainage. One patient died after 8th cycle of TACE from hepatic and renal failure. After TACE, regression of the carcinoid syndrome was noted in 8 of 9 patients. Computed tomography showed complete or partial tumor response in 50% of patients. Ten patients are alive in 18-123 (mean 66) months after the beginning of TACE. The mean survival of 20 patients who died was 32 months; the 1-, 3- и 5-year survival is 85%, 49% and 27%, respectively. TACE is a relatively safe and effective treatment of patients with unresectable carcinoid liver metastases. Both the tumor growth and carcinoid syndrome resistant to medical therapy should be considered indications to TACE.