Role of hepatic arterial embolisation in the carcinoid syndrome.

Maton, Paul N.; Camilleri, M.; Griffin, George E.; Allison, David J.; Hodgson, H. J. F.; Chadwick, V. S.

doi:10.1136/bmj.287.6397.932

Cited by 83 publications

(26 citation statements)

References 6 publications

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“…The first embolisation was directed against the lobe with largest tumour burden. During and after embolisation all patients were given broadspectrum antibiotics prophylactically [15]. After com pletion of the ischaemic treatment, all patients were offered adjuvant therapy with low doses of octreotide (50-200 pg daily), which w'as accepted by 19 out of 22 patients.…”

Section: Ischaemic Treatment O F Liver Métastasés and Adjuvant Medicamentioning

confidence: 99%

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Management of Disseminated Midgut Carcinoid Tumours

et al. 1991

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Forty-one patients with disseminated midgut carcinoid tumours were treated over a 6-year period according to a strict programme including primary surgical treatment. In 10 patients, a total remission of the disease was obtained. Patients with bilobar hepatic disease had ischaemic treatment of their liver metastases by hepatic arterial embolisation after primary surgical and medical treatment (low dose octreotide). Thus, by combining surgical, radiological and medical treatment modalities, we wanted to offer these patients optimal palliation. This treatment programme resulted in good symptomatic relief in all patients accompanied by a marked reduction in 5-hydroxyindoleacetic acid (5-HIAA) levels. At recurrence of symptoms in combination with rising 5-HIAA levels, embolisation was repeated. Ten of the treated patients have deceased during the observation period, but only 5 from their carcinoid disease.

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Section: Ischaemic Treatment O F Liver Métastasés and Adjuvant Medicamentioning

confidence: 99%

“…Cholecys tectomies were performed to facilitate future isch aemic treatment without risk for gangrene of the gall bladder [15]. In patients subsequently undergoing he patic arterial embolisation, the collateral blood sup ply was reduced by division of the hepatic ligaments and isolation of the common bile duct [16].…”

Section: Surgical Treatmentmentioning

confidence: 99%

Management of Disseminated Midgut Carcinoid Tumours

et al. 1991

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“…For Mitty et al [5], life span from the onset of flushing in patients with carcinoid syndrome rises from 3.2 to 5.4 years after embolization. However, this increasing of life expectancy is difficult to assess for most authors [6,11] who emphasize that the impact of this treatment on the medial survival time cannot be demonstrated.…”

Section: Resultsmentioning

confidence: 99%

“…Three kinds of effect can be studied: survival time, secretion rates, and tumor size. Most authors [6,7,11] note marked palliation but are unable to state if therapy increases life expectancy. This is due to short series and a frequent spontaneously long survival time of endocrine malignancies.…”

Section: Discussionmentioning

confidence: 99%

Pancreatic Islet Cell Tumors Metastatic to the Liver: Treatment by Hepatic Artery Chemo-Embolization

Valette

Souquet²

1989

Horm Res

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The embolization of hepatic metastases of pancreatic islet cell tumors achieves a tumor necrosis without liver failure owing to double hepatic blood supply. The arterial chemotherapy performed at the same time delivers a large amount of cytotoxic agent directly into the tumor. Tumor bulk reducing and decreasing of production of pharmacologically active substances may be obtained to some degree. Although an objective documentation of the therapeutic effect is difficult to obtain, several series emphasize that the embolization provides a partial and transient palliative remission. Therefore, the chemo-embolization should be included in a multidisciplinary approach of metastatic endocrine malignancies in combination with surgical resection, systemic antineoplastic chemotherapy, and antihormonal therapy.

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“…Broad spectrum antibiotics were given preoperatively (cf. Maton et al, 1983). Embolisation was monitored by fluoroscopy and the procedure was terminated when injected contrast medium stayed in main arterial branches for more than 30sec (Lunderquist et al, 1982).…”

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confidence: 99%