Safety and Efficacy of Hepatic Artery Embolization in Treating Solitary Fibrous Tumor Metastatic to the Liver

Abstract

The aim of this study was to evaluate safety and survival following hepatic artery embolization (HAE) for metastatic solitary fibrous tumor (SFT) in the liver. All patients with SFT metastatic to liver treated with HAE were retrospectively analyzed. Tumor response was evaluated using mRECIST. Objective response, overall survival (OS), and progression-free survival (PFS) were evaluated using Kaplan–Meier and multivariate Cox proportional hazard ratio. Adverse events were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 5.0. Twelve patients (6 males and 6 females, mean age: 42.5 ± 13 years; 24–65) were treated with 33 embolizations. Anatomical sites of origin for SFT were the head and neck (n = 6; 50%), pelvis (n = 2), pleura (n = 2), retroperitoneal (n = 1), and thigh (n = 1). The median follow-up from first HAE was 4.5 years (3–7.9). 84% of the patients showed objective response [42% complete response (CR) plus 42% partial response (PR)] to HAE by mRECIST (95% CI, 60–99%). Patients with CR to HAE had significantly higher OS compared to others (p<0.02). The postembolization median OS was 4 years (95% CI, 2.3–5.2), and mean PFS, for intra- or extrahepatic progression of disease, was 6 months (95%, CI, 3.2–7.1). One patient developed pneumonia/sepsis and died 27 days postembolization, possibly not directly related to embolization. No grade III or IV adverse events were identified in the remaining patients. In conclusion, HAE for metastatic liver SFT is a relatively safe treatment option with high response rate and should be considered as a treatment option for metastatic liver SFT. In our cohort of patients with metastatic SFT to the liver, we observed a median OS of 4 years following HAE. Further studies are needed to confirm the efficacy of HAE.

Targeting-intratumoral-lactic-acidosis transcatheter-arterial-chemoembolization for non-islet cell tumor hypoglycemia secondary to a liver metastatic solitary fibrous tumor: A case report and literature review

“…The best treatment for SFTs is complete resection of the tumor. Nevertheless, when curative resection is not available, metastasectomy, chemotherapy, and radiotherapy may be beneficial ( 18 , 19 ). A retrospective work ( n = 64) suggested that surgical resection of localized SFT can result in a 10-year overall survival (OS) of 58% when compared to that of metastatic SFT, which is 11% ( 21 ).…”

“…Velayati et al. summarized the safety and efficacy of the treatment of TACE ( 19 ). However, TACE may not always be effective.…”

“…However, more study is needed to verify the effects of these drugs ( 24 ). For primary and metastatic liver SFTs, local-regional treatments such as transcatheter arterial chemoembolization (TACE) have been reported ( 19 , 25 ). Zhong et al.…”

“…However, when curative resection is not feasible, short-term therapy, including continuous intravenous infusion of glucose and medical therapy, is beneficial. Other treatments include adjuvant chemotherapy and radiotherapy (18,19). It is reported that pazopanib can effectively control the progression of the tumor and can be considered a first-line treatment for some advanced typical SFTs (20)(21)(22)(23).…”

Postoperative Morbidity After Radical Resection of Retroperitoneal Solitary Fibrous Tumor

“…It has been employed to effectively treat blood-rich tumors. Since a huge SFT usually has a large blood supply vessel, it has been reported that the blood loss during surgery was large ( 13 ), so preoperative selective embolization of the supply vessel of SFTs could reduce intraoperative blood loss without blood transfusion ( 30 , 31 ). In this study, seven patients received preoperative arterial embolization, and preoperative embolization was not found as a risk factor for postoperative complications in the risk factor analysis.…”