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Endocrine Abstracts (2013) 32 P531 | DOI: 10.1530/endoabs.32.P531

1Clinic for Endocrinology, Diabetes and Metabolic Diseases, Belgrade, Serbia; 2Centre for Radiology, Clinical Centre of Serbia, Belgrade, Serbia.


Introduction: Most patients with neuroendocrine tumors (NETs) present with liver involvement at the time of diagnosis. Trans-catheter arterial chemoembolization (TACE) is accepted treatment of patients with non-resectable hepatic metastases from NETs.

Aim: To analyze objective tumor response and clinical outcome in patients with hepatic metastases from NETs who underwent TACE.

Methods: Thirty-one patients underwent 140 TACE procedures. Kaplan–Meier method was used to calculate the progression-free survival (PFS) and overall survival (OS). Tumor responses were measured by CT and MRI, and were assessed using the RECIST criteria.

Results: NET originated from the pancreas (n=5), small bowel (n=11), colon (n=1), lung (n=5), unknown primary localization (n=9). Almost all patients (93.5%) had received medical treatment including octreotide, interferon-α, chemotherapy, and peptide-receptor-radionuclide therapy. According to WHO criteria, majority were well-differentiated neuroendocrine carcinomas (71.4%). Median OS for all NETs was 59 months (4–180) with 5-year survival of 58.9%. The 5-year OS rates for patients with pancreatic, carcinoid and unknown primary tumors were 33.3, 75 and 38.9% respectively. Median PFS for all patients was 32 months (1–139). The only group of patients with 5-year PFS was the one with carcinoid tumor (59.3%). None of the 31 patients had a complete response. After third TACE a partial response was observed in two, stable disease in eight patients and there was none of the patients with the progressive disease. After the fifth TACE partial response was observed in three, stable disease in five and progressive disease in four patients.

Conclusion: The OS after TACE for all NETs is approximately 5 years, and median time to progression is about 32 month. Patients with carcinoid tumors had better outcomes than others. TACE is effective in stabilization and reduction of tumor growth in patients with hepatic metastasis from NETs.

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