Metastatic neuroendocrine tumors to the liver: treatment with bland embolization versus radioembolization

Abstract

Purpose To compare the overall survival, time to progression, and complication rates of radioembolization and bland embolization in patients with neuroendocrine tumor metastatic to the liver. Materials and Methods A total of 45 patients underwent embolization procedures for treatment of metastatic neuroendocrine tumor at our institution: 29 patients (13 males, mean age 56) were treated with bland embolization from 2/2004 to 5/2011 and 17 patients (9 males, mean age 57) were treated with radioembolization from 3/2008 to 6/2012. Medical records and imaging were retrospectively reviewed to determine the overall survival and time to progression after treatment. Survival and time to progression were estimated using the Kaplan-Meier method and compared with the log rank test. Results Overall survival at 6 and 12 months after therapy were 93% and 82% after bland embolization compared to 85% and 68% after radioembolization respectively (p=0.92). Survival subanalysis for carcinoid and non-carcinoid tumors also demonstrated similar overall survival between bland embolization and radioembolization. Freedom from progression at 6 and 12 months were 47% and 37% after bland embolization and 43% and 35% after radioembolization (p = 0.30). Again, no significant differences were identified comparing bland embolization to radioembolization based on tumor type. In the bland embolization group, one patient developed a hepatic abscess requiring drainage. In the radioembolization group, one patient developed an ulcer and one had severe gastritis, both treated conservatively. No cases of hepatic failure were encountered. Conclusion Treatment of neuroendocrine tumors metastatic to the liver with bland embolization and radioembolization demonstrated similar overall survival and time to progression.