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Liu Y, Zhou B, Tang W, Xu D, Yan Z, Ren L, Zhu D, He G, Wei Y, Chang W, Xu J. Preoperative transarterial chemoembolization with drug-eluting beads (DEB-TACE) in patients undergoing conversional hepatectomy: a propensity-score matching analysis. Eur Radiol 2023; 33:1022-1030. [PMID: 36066736 DOI: 10.1007/s00330-022-09063-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 06/30/2022] [Accepted: 07/24/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Patients with colorectal liver metastases (CRLM) who underwent hepatic resection after conversion therapy had a high recurrence rate of nearly 90%. Preoperative DEB-TACE has the potential to prevent postoperative recurrence which has not been elucidated. The objective of this study was to evaluate the safety and efficacy of preoperative DEB-TACE. MATERIALS AND METHODS Patients with CRLM who underwent liver resection from June 1, 2016, to June 30, 2021, were collected and those who received conversional hepatectomy were included in this study. Patients with preoperative DEB-TACE were propensity-score matched in a 1:1 ratio to patients without preoperative DEB-TACE. Short-term outcomes and recurrence-free survival (RFS) were compared between the two groups. RESULTS After PSM, 44 patients were included in each group. The toxicities of DEB-TACE were mild and could be managed by conservative treatment. Overall response rate (ORR) of conversion therapy (75.0% vs. 81.2%, p = 0.437) and postoperative complication of hepatic resection (27.3% vs. 20.5%, p = 0.453) were similar between the two groups. The median RFS of the DEB-TACE group (10.7 months, 95%CI: 6.6-14.8 months) was significantly longer than that of the control group (8.1 months, 95%CI: 3.4-12.8 months) (HR: 0.60, 95%CI: 0.37-0.95, p = 0.027). CONCLUSIONS In patients who became resectable after conversion therapy, preoperative DEB-TACE might be a safe option to achieve longer RFS. KEY POINTS • This is a propensity-score matching study comparing patients who underwent conversional hepatectomy with or without preoperative DEB-TACE. • The preoperative DEB-TACE was safe and with mild toxicities (without toxicities more than CTCAE grade 3). • The preoperative DEB-TACE significantly prolonged the RFS of those patients who underwent conversional hepatectomy (10.7 vs. 8.1 months, p = 0.027).
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Affiliation(s)
- Yu Liu
- Colorectal Cancer Centre, Zhongshan Hospital, Fudan University, Shanghai, China.,Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Engineering Research Centre of Colorectal Cancer Minimally Invasive, Shanghai, China
| | - Bo Zhou
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wentao Tang
- Colorectal Cancer Centre, Zhongshan Hospital, Fudan University, Shanghai, China.,Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Engineering Research Centre of Colorectal Cancer Minimally Invasive, Shanghai, China
| | - Donghao Xu
- Colorectal Cancer Centre, Zhongshan Hospital, Fudan University, Shanghai, China.,Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zhiping Yan
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Li Ren
- Colorectal Cancer Centre, Zhongshan Hospital, Fudan University, Shanghai, China.,Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Engineering Research Centre of Colorectal Cancer Minimally Invasive, Shanghai, China
| | - Dexiang Zhu
- Colorectal Cancer Centre, Zhongshan Hospital, Fudan University, Shanghai, China.,Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Engineering Research Centre of Colorectal Cancer Minimally Invasive, Shanghai, China
| | - Guodong He
- Colorectal Cancer Centre, Zhongshan Hospital, Fudan University, Shanghai, China.,Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Engineering Research Centre of Colorectal Cancer Minimally Invasive, Shanghai, China
| | - Ye Wei
- Colorectal Cancer Centre, Zhongshan Hospital, Fudan University, Shanghai, China.,Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Engineering Research Centre of Colorectal Cancer Minimally Invasive, Shanghai, China
| | - Wenju Chang
- Colorectal Cancer Centre, Zhongshan Hospital, Fudan University, Shanghai, China. .,Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China. .,Shanghai Engineering Research Centre of Colorectal Cancer Minimally Invasive, Shanghai, China.
| | - Jianmin Xu
- Colorectal Cancer Centre, Zhongshan Hospital, Fudan University, Shanghai, China. .,Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China. .,Shanghai Engineering Research Centre of Colorectal Cancer Minimally Invasive, Shanghai, China.
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Boeken T, Moussa N, Pernot S, Abed A, Dean C, Taieb J, Sapoval M, Pellerin O. Does Bead Size Affect Patient Outcome in Irinotecan-Loaded Beads Chemoembolization Plus Systemic Chemotherapy Regimens for Liver-Dominant Colorectal Cancer? Results of an Observational Study. Cardiovasc Intervent Radiol 2020; 43:866-874. [PMID: 32103303 DOI: 10.1007/s00270-020-02438-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 02/18/2020] [Indexed: 01/10/2023]
Abstract
PURPOSE We investigated the clinical effects of bead size in irinotecan-loaded beads chemoembolization (DEBIRI) used for treating liver-dominant colorectal cancer. MATERIALS AND METHODS Between March 2009 and January 2018, all consecutive patients with colorectal cancer liver metastases referred for DEBIRI at our tertiary center were included in an observational study. Patients were treated exclusively with either 100-mg irinotecan-loaded DC beads of 70-150 μm (small bead group or SB) or 100-300 μm (large bead group or LB) in diameter, in addition to systemic therapy. Liver tumor response rate at 3 months, liver and overall progression-free survival (PFS) and overall survival were estimated. RESULTS In total, 84 patients with liver-dominant progressive disease underwent 232 DEBIRI sessions. Fifty-four patients were treated in the SB group and 30 patients in the LB group. Liver progression-free rates at 3 months were 86.7% for the LB group and 79.6% for the SB group (NS). Median liver-PFS and overall PFS were, respectively, 7.15 months and 7.15 months for the LB group and 7.65 and 7.55 months for the SB group (NS). Median overall survival was 13.04 months for the LB group and 15.59 months for the SB group (p = 0.04). Specific treatment grade 3 + 4 toxicity occurrence was 5 (17%) in the LB group and 20 (37%) in the SB group. CONCLUSION No significant difference in patient outcome was observed between DEBIRI bead sizes of 70-150 μm and 100-300 μm. A trend toward higher treatment-specific toxicity was observed with the smaller beads.
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Affiliation(s)
- Tom Boeken
- Interventional Radiology Department, Hôpital Européen Georges Pompidou, 20 Rue Leblanc, 75015, Paris, France.
- Université Paris Descartes - Sorbonne - Paris Cité, Paris, France.
| | - Nadia Moussa
- Interventional Radiology Department, Hôpital Européen Georges Pompidou, 20 Rue Leblanc, 75015, Paris, France
- Université Paris Descartes - Sorbonne - Paris Cité, Paris, France
| | - Simon Pernot
- Université Paris Descartes - Sorbonne - Paris Cité, Paris, France
- Digestive Oncology Department, Hôpitaux de Paris Hôpital Européen Georges Pompidou, 20 Rue Leblanc, 75015, Paris, France
- INSERM URM, 970 Equipe 2 Imagerie de L'angiogenèse, Paris, France
| | - Abdellahi Abed
- Interventional Radiology Department, Hôpital Européen Georges Pompidou, 20 Rue Leblanc, 75015, Paris, France
| | - Carole Dean
- Interventional Radiology Department, Hôpital Européen Georges Pompidou, 20 Rue Leblanc, 75015, Paris, France
| | - Julien Taieb
- Université Paris Descartes - Sorbonne - Paris Cité, Paris, France
- Digestive Oncology Department, Hôpitaux de Paris Hôpital Européen Georges Pompidou, 20 Rue Leblanc, 75015, Paris, France
- INSERM URM, 970 Equipe 2 Imagerie de L'angiogenèse, Paris, France
| | - Marc Sapoval
- Interventional Radiology Department, Hôpital Européen Georges Pompidou, 20 Rue Leblanc, 75015, Paris, France
- Université Paris Descartes - Sorbonne - Paris Cité, Paris, France
- INSERM URM, 970 Equipe 2 Imagerie de L'angiogenèse, Paris, France
| | - Olivier Pellerin
- Interventional Radiology Department, Hôpital Européen Georges Pompidou, 20 Rue Leblanc, 75015, Paris, France
- Université Paris Descartes - Sorbonne - Paris Cité, Paris, France
- INSERM URM, 970 Equipe 2 Imagerie de L'angiogenèse, Paris, France
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Nielsen K, van Tilborg AAJM, Scheffer HJ, Meijerink MR, de Lange-de Klerk ESM, Meijer S, Comans EFI, van den Tol MP. PET-CT after radiofrequency ablation of colorectal liver metastases: suggestions for timing and image interpretation. Eur J Radiol 2013; 82:2169-75. [PMID: 24021269 DOI: 10.1016/j.ejrad.2013.08.024] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 07/30/2013] [Accepted: 08/02/2013] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The main area of concern regarding radiofrequency ablation (RFA) of colorectal liver metastases is the risk of developing a local site recurrence (LSR). Reported accuracy of PET-CT in detecting LSR is high compared to morphological imaging alone, but no internationally accepted criteria for image interpretation have been defined. Our aim was to assess criteria for FDG PET-CT image interpretation following RFA, and to define a timetable for follow-up detection of LSR. METHODS Patients who underwent RFA for colorectal liver metastases between 2005 and 2011, with FDG-PET follow-up within one year after treatment were included. Results of repeat FDG-PET scans were evaluated until a LSR was diagnosed. Results. One hundred-seventy scans were obtained for 79 patients (179 lesions), 57 scans (72%) were obtained within 6 months of treatment. Thirty patients developed local recurrence; 29 (97%) within 1 year. Only 2% of lesions of <1cm and 4% of <2 cm showed a LSR. CONCLUSION The majority of local site recurrences are diagnosed within one year after RFA. Regular follow-up using FDG PET-CT within this period is advised, so repeated treatment can be initiated. Rim-shaped uptake may be present until 4-6 months, complicating evaluation. The benefit in the follow-up of lesions <2 cm may be limited.
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Affiliation(s)
- Karin Nielsen
- Department of Surgery, VU University Medical Centre, Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
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Tao HQ, Lin YZ, Yin HR, Gu QL, Zhu ZG, Yao M. Effects of Linomide on growth and metastasis of implanted human gastric cancer in nude mice. World J Gastroenterol 1997; 3:153-5. [PMID: 27239130 PMCID: PMC4842871 DOI: 10.3748/wjg.v3.i3.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/1996] [Revised: 02/19/1997] [Accepted: 03/10/1997] [Indexed: 02/06/2023] Open
Abstract
AIM: To elucidate the effect of angiogenesis inhibitor, Linomide, on tumor growth and metastasis in nude mice implanted with human gastric cancer.
METHODS: A metastatic model of gastric cancer was established using orthotopic implantation of histologically intact tumor tissues into the gastric wall of nude mice. Linomide (0, 80, 160 mg·kg-1) was given p.o. every day after the implantation, and the mice were sacrificed after 10 wk to detect tumor size and metastasis. The microvessel counts were measured by immunohistochemical staining using a monoclonal antibody against Human Factor VIII related antigen.
RESULTS: Linomide treatment significantly decreased the size of the implanted tumors (control group: 1.36 ± 0.81 cm3vs Linomide treated group: 0.84 ± 0.51 cm3 and 0.62 ± 0.35 cm3, P < 0.05 and 0.01, respectively). Additionally, an antimetastatic effect of Linomide was clearly demonstrated in a dose dependent manner: mice given 80 mg·kg-1 Linomide developed liver metastasis in 4 of 10 cases, mice given 160 mg/kg developed metastasis in only 1 of 10 mice, while it developed in 19 of 28 mice of the control group (P < 0.05 and 0.01, respectively). The number of metastatic foci was also significantly less in the treated group. Furthermore, the microvessel counts in tumors of treated mice was reduced by 33%-42% as compared with the control tumors (P < 0.01).
CONCLUSION: Linomide has a strong inhibitory activity against in vivo tumor growth and metastasis of gastric cancer, effectively suppressing the growth of the primary tumor, preventing liver metastasis, and attenuating the rate of neovascularization.
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