Repeated Transarterial Chemoembolization in the Treatment of Liver Metastases of Colorectal Cancer: Prospective Study

Vogl, Thomas J.; Gruber, Tatjana; Balzer, J. O.; Eichler, Katrin; Hammerstingl, Renate; Zangos, S

doi:10.1148/radiol.2501080295

Cited by 120 publications

(67 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Most common effects of post-embolization syndrome are pain, nausea, vomiting and fatigue. 7,10 Post-embolization pain represents one of the most common side effects of chemoembolization. Intra-arterial injection of lidocaine has been reported to reduce the severity and duration of postembolization pain.…”

Section: Current Trends In Interventional Treatment Of Colorectal Canmentioning

confidence: 99%

“…7,10 Several previous studies addressed the safety of performing TACE on an outpatient basis. Mitchell et al 20 reported the safety of the outpatient concept in carefully selected patients, where 131 from 133 sessions were performed on outpatient cases and only 2 required readmission.…”

Section: Current Trends In Interventional Treatment Of Colorectal Canmentioning

confidence: 99%

“…For the remaining patients, locoregional therapies can be used for neoadjuvant, symptomatic and palliative treatments. 6,7 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Current strategies in interventional oncology of colorectal liver metastases

Gruber‐Rouh

Marko

Thalhammer

et al. 2016

BJR

View full text Add to dashboard Cite

The adequate treatment of non-resectable liver metastases from colorectal cancer which are resistant to systemic chemotherapy currently provides a great challenge. The aim is to identify and review key strategies in the treatment of colorectal liver metastases. A search for current literature on the topic of interventional strategies for colorectal metastases was performed in Medline in order to achieve this goal. Studies before 2005 and with ,20 patients treated for colorectal metastases were excluded. Transarterial chemoembolization (TACE), transarterial embolization and selective internal radiation therapy (SIRT) were identified as examples of regional strategies for colorectal liver metastases, utilizing the unique blood supply of the liver. Radiofrequency ablation (RFA), microwave ablation (MWA) and cryoablation were selected as examples for currently available ablative techniques. Median survival in the key studies reviewed ranged from 7.7 to 28.6 for TACE, 8.3-12.6 for SIRT, 8.2-53.2 for RFA and 29-43 months for MWA. After review of the literature, it can be concluded that interventional oncologic therapies are a safe and effective method for treating colorectal liver metastases. The use of new chemotherapeutic agents for local therapy and new ablation technologies and techniques may increase patient survival and allows a neoadjuvant therapy setting. In addition, a combination of local therapies may be used to increase effectiveness in the future, which is subject to further research. INTRODUCTIONColorectal cancer is one of the most common cancers that shows fatal progression.1 Colorectal carcinoma most commonly metastasises to the liver due to haematogenous spread.2 At the time of diagnosis, 20-30% of patients have liver metastases, and during the course of disease, up to 60% of patients develop hepatic metastases.3 Although surgical excision is the first-line treatment for colorectal metastases, only 10-25% of patients are candidates for surgical resection. 4 Neoadjuvant systemic chemotherapy only allows 10-30% of patients with unresectable colorectal liver metastases sufficient downsizing for resection.

show abstract

Section: Current Trends In Interventional Treatment Of Colorectal Canmentioning

confidence: 99%

Section: Current Trends In Interventional Treatment Of Colorectal Canmentioning

confidence: 99%

See 1 more Smart Citation

Current strategies in interventional oncology of colorectal liver metastases

Gruber‐Rouh

Marko

Thalhammer

et al. 2016

BJR

View full text Add to dashboard Cite

show abstract

“…Such treatment methods include hepatic arterial infusion (HAI) of chemotherapy, transarterial chemoembolization (TACE), chemoembolization with chemotherapeutically loaded beads, radiofrequency ablation (RFA), cryotherapy, laser-induced thermotherapy (LITT) and selective internal radiation therapy (SIRT). [22][23][24][25][26][27][28][29][30] Regarding liver metastases of CRC there are few studies addressing the possible prognostic factors of liver metastases from CRC under TACE. The current single-center study was performed on a large number of patients (n 5 564) to determine the response and survival rates of patients who undergo TACE of liver metastases of CRC and to compare the effect of four different regimens of chemotherapy.…”

mentioning

confidence: 99%

Transarterial chemoembolization of unresectable systemic chemotherapy‐refractory liver metastases from colorectal cancer: Long‐term results over a 10‐year period

Gruber‐Rouh

Naguib

Eichler

et al. 2013

Intl Journal of Cancer

Self Cite

View full text Add to dashboard Cite

The aims of the study were to evaluate therapeutic efficacy and to determine the prognostic factors for treatment success in patients with liver metastases from colorectal cancer (CRC) treated with transarterial chemoembolization (TACE). A total of 564 patients (mean age, 60.3 years) with liver metastases of CRC were repeatedly treated with TACE. In total, 3,384 TACE procedures were performed (mean, six sessions per patient). The local chemotherapy protocol consisted of mitomycin C alone (43.1%), mitomycin C with gemcitabine (27.1%), mitomycin C with irinotecan (15.6%) or mitomycin C with irinotecan and cisplatin (15.6%). Embolization was performed with lipiodol and starch microspheres. Tumor response was evaluated using magnetic resonance imaging or computed tomography. The change in tumor size was calculated and the response was evaluated according to the RECIST-Criteria. Survival rates were calculated according to the Kaplan-Meier method. Prognostic factors for patient's survival were evaluated using log-rank test. Evaluation of local tumor control showed partial response in 16.7%, stable disease in 48.2% and progressive disease in 16.7%. The 1-year survival rate after chemoembolization was 62%, the 2-year survival rate was 28% and the 3-year survival rate was 7%. Median survival from the start of chemoembolization treatment was 14.3 months. The indication (p 5 0.001) and initial tumor response (p 5 0.015) were statistically significant factors for patient's survival. TACE is a minimally invasive therapy option for controlling local metastases and improving survival time in patients with hepatic metastases from CRC. TN stage, extrahepatic metastases, number of lesions, tumor location within the liver and choice of chemotherapy protocol of TACE are none significant factors for patient's survival.The development of liver metastases in patients with colorectal cancer (CRC) substantially affects the prognosis of the patient. At the time of first diagnosis of CRC, 20-50% of all patients already present with synchronous liver metastases. Liver metastases develop in about 60-70% of CRC patients during the course of their disease and are the most common cause of death of patients with CRC. [1][2][3] Resection is the only potentially curative therapy for patients with liver metastases from CRC. 4,5 Only 20% of patients with liver metastases will be candidates for resection. With modern oncosurgical approaches, patients with resected liver metastases can experience up to 50-60% 5-year overall survival and a median survival of 46-64 months.6-8 Systemic chemotherapy may achieve this goal in 10-20% of initially unresectable patients. 9,10 The high rate of inoperable patients and intrahepatic recurrence rates are another relevant problem. Currently, the standard first-line treatment of metastatic CRC is a combination of infusional 5-FU, folinic acid with either irinotecan (FOLFIRI) or oxaliplatin (FOLFOX). The response rate to these schedules is 50%, and 50% of patients will progress within 10 months. In second-line therap...

show abstract

“…Several studies suggest that conventional tace is associated with improved survival in patients with chemorefractory crc with liver metastases 66,67 ; however, most studies lack a control group. Phase ii/iii trials using deb-tace have reported response rates of approximately 70%, with pfs durations of 7-8 months and a mos of 22-25 months [68][69][70] .…”

Section: Summary Of Evidencementioning

confidence: 99%

Consensus Statement: The 16th Annual Western Canadian Gastrointestinal Cancer Consensus Conference; Saskatoon, Saskatchewan; September 5–6, 2014

et al. 2015

View full text Add to dashboard Cite

The 16th annual Western Canadian Gastrointestinal Cancer Consensus Conference was held in Saskatoon, Saskatchewan, September 4–5, 2014. The Consensus Conference is an interactive, multidisciplinary event attended by health care professionals from across western Canada (British Columbia, Alberta, Saskatchewan, and Manitoba) involved in the care of gastrointestinal cancer. Surgical, medical, and radiation oncologists; pathologists; radiologists; and allied health care professionals participated in presentation and discussion sessions for the purposes of developing the recommendations presented here. This consensus statement addresses current issues in the management of colorectal cancer.

show abstract

Repeated Transarterial Chemoembolization in the Treatment of Liver Metastases of Colorectal Cancer: Prospective Study

Abstract: Chemoembolization is a minimally invasive therapy option for palliative treatment of liver metastases in patients with colorectal cancer, with similar results among three chemoembolization protocols.

Cited by 120 publications

References 33 publications

Current strategies in interventional oncology of colorectal liver metastases

Current strategies in interventional oncology of colorectal liver metastases

Transarterial chemoembolization of unresectable systemic chemotherapy‐refractory liver metastases from colorectal cancer: Long‐term results over a 10‐year period

Consensus Statement: The 16th Annual Western Canadian Gastrointestinal Cancer Consensus Conference; Saskatoon, Saskatchewan; September 5–6, 2014

Contact Info

Product

Resources

About