Palliative embolization of metastases from kidney cancer

Abstract

4663 Background: Treatment options for symptomatic patients with advanced kidney cancer are limited. Catheter-based embolization of metastatic lesions from kidney cancer has been used in the pre-operative setting to manage operative blood loss. Palliative benefit from the embolization procedure itself has been reported in several small case series. We performed a retrospective review of patients who had undergone catheter-based embolization of metastases from kidney cancer at our institution purely for palliative purposes. Methods: Records from 22 patients who had undergone palliative embolization were reviewed. Data collected included indication, prior local or systemic therapies, complications, symptom relief, and any local therapy required subsequently. Relief from pain was rated complete (CR) if patients were able to discontinue narcotics and partial (PR) if narcotic use was decreased by ≥ 50%. Results: 39 procedures were performed in 22 patients (34 for pain alone, 3 for hemorrhage, 1 for airway compromise, 1 for spinal cord compression and pain). Pain relief was CR in 20 (57%) and PR in 12 (34%) in the 35 procedures performed for pain control. In all 3 cases performed for bleeding, bleeding stopped (transfusion independence) for a duration of 1–8 months. The patient with airway compromise achieved a complete radiographic response with patency of airway. In the case of the spinal cord compression, the patient appreciated partial improvement in leg strength. Complications included one pulmonary embolus and one incomplete T12 paraparesis. Conclusions: Catheter-based arterial embolization can provide a safe and effective palliative option for patients with metastatic kidney cancer. No significant financial relationships to disclose.