REGULAR CONTENT
Final ID
494
Type
Original Scientific Research-Oral or Pos
Authors
E Alexander1, G Fryhofer2, G Nadolski1, J Mondschein3, S Stavropoulos4, M Soulen5
Institutions
1University of Pennsylvania, Philadelphia, PA, 2Hospital of the University of Pennsylvania, PHILADELPHIA, PA, 3N/A, Moorestown, NJ, 4N/A, Bryn Mawr, PA, 5N/A, Lafayette Hill, PA
Purpose
To evaluate safety, time to progression (TTP), and overall survival (OS) in patients with liver metastases (LM) treated with transarterial chemoembolization (TACE) followed by ablation.
Materials & Methods
Retrospective study of all patients with LM treated with combined TACE and ablation from August 1998-July 2015. 42 patients were treated (18 colorectal, 5 sarcoma, 5 cholangiocarcinoma, 4 NET, 4 pancreatic adenocarcinoma, 3 breast, 3 other). Medical records were reviewed for patient demographics, tumor characteristics, response, time to local recurrence, and survival. Kaplan-Meier (K-M) method was used to estimate time event data and comparisons were performed using t-test and Wilcoxon rank sum test.
Results
Median follow-up was 10.3 mo (range, 0-196 mo). 18 patients had 1 metastasis, 16 had 2-5, and 8 had >5. Median size of the index lesion was 4.7 cm (range, 1.- 8 .0 cm). Initial tumor response (mRECIST) was available for 41/44 treated lesions with 32 CR (78.0%), 8 PR (19.5%), and 1 PD (2.4%). Long-term imaging follow-up was available for 38/42 patients. Freedom from local recurrence was 61% at 1-year and 47% at 2- and 3-years (median TTP 18.1 mo). OS was 58%, at 1-year, 33% at 2-years, and 21% at 3-years (median OS 15.6 mo). Index tumor size was not a predictor of TTP or OS. Solitary metastasis was associated with longer OS (21.3 mo) compared to multifocal disease (13.6 mo, p=0.017). ECOG status of 0 (p=0.026) was associated with increased OS. There was no difference in TTP or OS between patients with colorectal metastases compared to other malignancies. Complications occurred in 19 patients (45%); 8 major complications included hospitalization for fever (n=2), hepatic abscess (n=2), fall post-procedure requiring transfusion (n=1), portal vein thrombosis causing lobar infarct (n=1), biliary fistula (n=1), and retroperitoneal hematoma (n=1).
Conclusions
Combined TACE and ablation can be an effective treatment option for local tumor control in patients with liver metastases with an A0 ablation rate of 78% for metastases up to 8cm. Tumor type was not predictive of TTP or OS.
Final ID
494
Type
Original Scientific Research-Oral or Pos
Authors
E Alexander1, G Fryhofer2, G Nadolski1, J Mondschein3, S Stavropoulos4, M Soulen5
Institutions
1University of Pennsylvania, Philadelphia, PA, 2Hospital of the University of Pennsylvania, PHILADELPHIA, PA, 3N/A, Moorestown, NJ, 4N/A, Bryn Mawr, PA, 5N/A, Lafayette Hill, PA
Purpose
To evaluate safety, time to progression (TTP), and overall survival (OS) in patients with liver metastases (LM) treated with transarterial chemoembolization (TACE) followed by ablation.
Materials & Methods
Retrospective study of all patients with LM treated with combined TACE and ablation from August 1998-July 2015. 42 patients were treated (18 colorectal, 5 sarcoma, 5 cholangiocarcinoma, 4 NET, 4 pancreatic adenocarcinoma, 3 breast, 3 other). Medical records were reviewed for patient demographics, tumor characteristics, response, time to local recurrence, and survival. Kaplan-Meier (K-M) method was used to estimate time event data and comparisons were performed using t-test and Wilcoxon rank sum test.
Results
Median follow-up was 10.3 mo (range, 0-196 mo). 18 patients had 1 metastasis, 16 had 2-5, and 8 had >5. Median size of the index lesion was 4.7 cm (range, 1.- 8 .0 cm). Initial tumor response (mRECIST) was available for 41/44 treated lesions with 32 CR (78.0%), 8 PR (19.5%), and 1 PD (2.4%). Long-term imaging follow-up was available for 38/42 patients. Freedom from local recurrence was 61% at 1-year and 47% at 2- and 3-years (median TTP 18.1 mo). OS was 58%, at 1-year, 33% at 2-years, and 21% at 3-years (median OS 15.6 mo). Index tumor size was not a predictor of TTP or OS. Solitary metastasis was associated with longer OS (21.3 mo) compared to multifocal disease (13.6 mo, p=0.017). ECOG status of 0 (p=0.026) was associated with increased OS. There was no difference in TTP or OS between patients with colorectal metastases compared to other malignancies. Complications occurred in 19 patients (45%); 8 major complications included hospitalization for fever (n=2), hepatic abscess (n=2), fall post-procedure requiring transfusion (n=1), portal vein thrombosis causing lobar infarct (n=1), biliary fistula (n=1), and retroperitoneal hematoma (n=1).
Conclusions
Combined TACE and ablation can be an effective treatment option for local tumor control in patients with liver metastases with an A0 ablation rate of 78% for metastases up to 8cm. Tumor type was not predictive of TTP or OS.