Outcomes With Liver-Directed Therapy for Genitourinary Malignancies: Single-Institution Experience.

Abstract

Abstract Purpose Liver metastasis in genitourinary (GU) malignancies signifies a poor prognosis and has a negative effect on patient survival. Selected patients with metastatic GU malignancies have liver-dominant disease. Liver-directed therapies (LDT) with conventional transarterial chemoembolization (cTACE) and transarterial radioembolization (TARE) have been well studied in primary liver cancer and metastatic hepatic disease and proven to be safe and efficacious in selected populations. Materials and Methods From 2005 to 2016, 32 patients with metastatic renal, bladder, or prostate cancer and liver-dominant metastases treated with cTACE or TARE were identified. Retrospective review of patient records was performed to assess baseline characteristics, imaging treatment response, survival, and treatment toxicity. Results The median survival from diagnosis of liver metastasis was 37 months in renal cell carcinoma (RCC), 8 months in transitional cell carcinoma (TCC), and 6 months in prostate carcinoma. 90% of patients with RCC maintained their ECOG performance status one-month post-treatment, as did 64% of the bladder and prostate groups. LDT was well tolerated for the most part. Conclusion LDT in patients with metastatic GU cancer is well tolerated and can lead to improved survival for some patients. Further studies are necessary to determine which patients may benefit the most.