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26 - Interventional Radiology for the Treatment of Liver Metastases from Neuroendocrine Tumors

from PART III - ORGAN-SPECIFIC CANCERS

Published online by Cambridge University Press:  18 May 2010

Thierry de Baère
Affiliation:
Professor, Department of Interventional Radiology Institut Gustave Roussy Villejuif, France
Jean-François H. Geschwind
Affiliation:
The Johns Hopkins University School of Medicine
Michael C. Soulen
Affiliation:
University of Pennsylvania School of Medicine
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Summary

Neuroendocrine gut and pancreatic tumors are rather rare malignant diseases, but development of new diagnostic tools (somatostatin receptor scintigraphy) and therapeutic options (somatostatin analogs, radioactive-labeled octreotide, transarterial therapy, radiofrequency ablation) make them of great interest to the medical community. The term neuroendocrine tumor encompasses a variety of relatively different diseases:

  • Carcinoid tumors, which are the most common, with an incidence of about 3 per 100,000 persons

  • Islet cell carcinomas, also called pancreatic endocrine tumors, with an incidence of about 0.3 per 100,000 persons

Carcinoid tumors arise most often from the small bowel, sometimes from pancreas, lung and bronchi, and more rarely from other organs such salivary glands or uterus but can arise from nearly everywhere due to the widespread diffusion of neuroendocrine cells, which give rise to the disease. Most often, they induce high levels of serotonin or chromogranin A. Islet cell carcinomas or pancreatic endocrine tumors arise from the pancreas and can produce insulin, glucagons, or vasoactive intestinal peptide (VIP). Production of various systemic hormones associated with specific immunohistochemical markers such as neurospecific enolase (NSE), synaptophysin, cytokeratin, chromogranin and CD 56 allows the diagnosis of these neuroendocrine tumors. For clinical considerations, the histopathologic grade of the tumor is an even more important factor than the histopathologic type. The grade obtained from the number of mitoses per microscope high-power field is linked to the aggressiveness of the disease and thus will influence therapeutic choices. Tumors with two or fewer mitoses are classified as low grade.

Type
Chapter
Information
Interventional Oncology
Principles and Practice
, pp. 301 - 310
Publisher: Cambridge University Press
Print publication year: 2008

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References

Soreide, O, Berstad, T, Bakka, A, et al. Surgical treatment as a principle in patients with advanced abdominal carcinoid tumors. Surgery, 1992; 111(1): 48–54.Google ScholarPubMed
Chamberlain, R S, Canes, D, Brown, K T, et al. Hepatic neuroendocrine metastases: Does intervention alter outcomes?J Am Coll Surg, 2000; 190(4): 432–445.CrossRefGoogle ScholarPubMed
Osborne, D A, Zervos, E E, Strosberg, J, et al. Improved outcome with cytoreduction versus embolization for symptomatic hepatic metastases of carcinoid and neuroendocrine tumors. Ann Surg Oncol, 2006; 13(4): 572–581.CrossRefGoogle ScholarPubMed
Roche, A, Girish, B V, Baere, T, et al. Trans-catheter arterial chemoembolization as first-line treatment for hepatic metastases from endocrine tumors. Eur Radiol, 2003; 13(1): 136–140.Google ScholarPubMed
Therasse, E, Breittmayer, F, Roche, A, et al. Transcatheter chemoembolization of carcinoid progressive liver metastasis. Radiology, 1993; 189: 541–547.CrossRefGoogle ScholarPubMed
Gupta, S, Johnson, M M, Murthy, R, et al. Hepatic arterial embolization and chemoembolization for the treatment of patients with metastatic neuroendocrine tumors: Variables affecting response rates and survival. Cancer, 2005; 104(8): 1590–1602.CrossRefGoogle Scholar
Sun, W, Lipsitz, S, Catalano, P. Phase II/II study of doxorubicin with fluorouracil compared with streptozocin with fluorouracil or dacarbazine in the treatment of advanced carcinoid tumors: Eastern Cooperative Oncology Group Study E1281. J Clin Oncol, 2005; 23(22): 4897–4904.CrossRefGoogle ScholarPubMed
Kouvaraki, M A, Ajani, J A, Hoff, P, et al. Fluorouracil, doxorubicin, and streptozocin in the treatment of patients with locally advanced and metastatic pancreatic endocrine carcinomas. J Clin Oncol, 2004; 22(23): 4762–4771.CrossRefGoogle ScholarPubMed
Arnold, R, Trautmann, M E, Creutzfeldt, W, et al. Somatostatin analogue octreotide and inhibition of tumour growth in metastatic endocrine gastroenteropancreatic tumours. Gut, 1996; 38(3): 430–438.CrossRefGoogle ScholarPubMed
Moertel, C G, Johnson, C M, McKusick, M A, et al. The management of patients with advanced carcinoid tumors and islet cell carcinomas. Ann Intern Med, 1994; 120(4): 302–309.CrossRefGoogle ScholarPubMed
Nobin, A, Mansson, B, Lunderquist, A. Evaluation of temporary liver dearterialization and embolization in patients with metastatic carcinoid tumour. Acta Oncologica, 1989; 28: 419–424.CrossRefGoogle ScholarPubMed
Ruutiainen, A T, Soulen, M C, Tuite, C M, et al. Chemoembolization and bland embolization of neuroendocrine tumor metastases to the liver. J Vasc Interv Radiol, 2007; 18: 847–855.CrossRefGoogle ScholarPubMed
Dominguez, S, Denys, A, Madeira, I, et al. Hepatic arterial chemoembolization with streptozotocin in patients with metastatic digestive endocrine tumours. Eur J Gastroenterol Hepatol, 2000; 12(2): 151–157.CrossRefGoogle ScholarPubMed
Baere, T, Dufaux, J, Roche, A, et al. Circulatory alterations induced by intra-arterial injection of iodized oil and emulsions of iodized oil and doxorubicin: Experimental study. Radiology, 1995; 194: 165–170.CrossRefGoogle ScholarPubMed
Baere, T, Denys, A, Briquet, R, et al. Modification of arterial and portal hemodynamic after injection of iodized oil in the hepatic artery: Experimental study. J Vasc Interv Radiol, 1998; 9: 305–310.CrossRefGoogle ScholarPubMed
Imaeda, T, Ymawaki, Y, Seki, M, et al. Lipiodol retention and massive necrosis after lipiodol-chemoembolization of hepatocellular carcinoma: Correlation between computed tomography and histopathology. Cardiovasc Intervent Radiol, 1993; 16: 209–213.CrossRefGoogle ScholarPubMed
Hong, K, Khwaja, A, Liapi, E, et al. New intra-arterial drug delivery system for the treatment of liver cancer: Preclinical assessment in a rabbit model of liver cancer. Clin Cancer Res, 2006; 12(8): 2563–2567.CrossRefGoogle Scholar
Baere, T, Roche, A, Amenabar, J M, et al. Liver abscess formation after local treatment of liver tumors. Hepatology, 1996; 23(6): 1436–140.CrossRefGoogle ScholarPubMed
Geschwind, J F, Kaushik, S, Ramsey, D E, et al. Influence of a new prophylactic antibiotic therapy on the incidence of liver abscesses after chemoembolization treatment of liver tumors. J Vasc Interv Radiol, 2002; 13(11): 1163–1166.CrossRefGoogle ScholarPubMed
Shalin, Patel S, Tuite, C M, Mondschein, J I, et al. Effectiveness of an aggressive antibiotic regimen for chemoembolization in patients with previous biliary intervention. J Vasc Interv Radiol, 2006; 17: 1931–1934.Google Scholar
Coenegrachts, K, Baere, TAbdel-Rehim, M, et al. TransArterial ChemoEmbolization (TACE) of neuroendocrine hepatic metastases using drug eluting beads (abstr). RSNA book of abstracts, 2005: 72.Google Scholar
Dromain, C, Baere, T, Lumbroso, J, et al. Detection of liver metastases from endocrine tumors: A prospective comparison of somatostatin receptor scintigraphy, computed tomography, and magnetic resonance imaging. J Clin Oncol, 2005; 23(1): 70–78.CrossRefGoogle ScholarPubMed
Kamel, I R, Bluemke, D A, Eng, J, et al. The role of functional MR imaging in the assessment of tumor response after chemoembolization in patients with hepatocellular carcinoma. J Vasc Interv Radiol, 2006; 17(3):505–512.CrossRefGoogle ScholarPubMed
Touzios, J G, Kiely, J M, Pitt, S C, et al. Neuroendocrine hepatic metastases: Does aggressive management improve survival?Ann Surg, 2005; 241(5): 776–783; discussion 83–85.CrossRefGoogle ScholarPubMed
Chu, Q D, Hill, H C, Douglass, H O Jr., et al. Predictive factors associated with long-term survival in patients with neuroendocrine tumors of the pancreas. Ann Surg Oncol, 2002; 9(9): 855–862.CrossRefGoogle ScholarPubMed
Roche, A, Girish, B V, Baere, T, et al. Prognostic factors for chemoembolization in liver metastasis from endocrine tumors. Hepatogastroenterology, 2004; 51(60): 1751–1756.Google ScholarPubMed
Eriksson, B K, Larsson, E G, Skogseid, B M, et al. Liver embolizations of patients with malignant neuroendocrine gastrointestinal tumors. Cancer, 1998; 83(11): 2293–2301.3.0.CO;2-E>CrossRefGoogle ScholarPubMed
Stokes, K R, Stuart, K, Clouse, M E. Hepatic arterial chemoembolization for metastatic endocrine tumors. J Vasc Interv Radiol, 1993; 4(3): 341–345.CrossRefGoogle ScholarPubMed
Brogsitter, C, Pinkert, J, Bredow, J, et al. Enhanced tumor uptake in neuroendocrine tumors after intraarterial application of 131I-MIBG. J Nucl Med, 2005; 46(12): 2112–2116.Google ScholarPubMed
McStay, M K, Maudgil, D, Williams, M, et al. Large-volume liver metastases from neuroendocrine tumors: Hepatic intraarterial 90Y-DOTA-lanreotide as effective palliative therapy. Radiology, 2005; 237(2): 718–726.CrossRefGoogle ScholarPubMed
Murthy, R, Gupta, S, Madoff, D C, et al. Feasibility of hepatic arterial therapy with Yttrium-90 microspheres (SIR-Spheres) in metastatic dominant progression after failure of multiple systemic and hepatic artery therapies [abstr]. Radiology, 2005; 237(suppl): 410.Google Scholar
Livraghi, T, Vettori, C, Lazzaroni, S. Liver metastases: Results of percutaneous ethanol injection in 14 patients. Radiology, 1991; 179: 709–712.CrossRefGoogle ScholarPubMed
Berber, E, Flesher, N, and Siperstein, A E. Laparoscopic radiofrequency ablation of neuroendocrine liver metastases. World J Surg, 2002; 26(8): 985–990.CrossRefGoogle ScholarPubMed
Wettstein, M, Vogt, C, Cohnen, M, et al. Serotonin release during percutaneous radiofrequency ablation in a patient with symptomatic liver metastases of a neuroendocrine tumor. Hepatogastroenterology, 2004; 51(57): 830–832.Google Scholar
Elias, D, Pietroantonio, Di D, Gachot, B, et al. Liver abscess after radiofrequency ablation of tumors in patients with a biliary tract procedure. Gastroenterol Clin Biol, 2006; 30(6–7): 823–827.CrossRefGoogle ScholarPubMed

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