经动脉栓塞与化疗栓塞治疗神经内分泌肝转移：倾向匹配分析

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hpb Pub Date : 2024-12-01 DOI:10.1016/j.hpb.2024.08.011

Samantha M. Ruff , Jin Y. Chang , Menglin Xu , Aslam M. Ejaz , Mary Dillhoff , Timothy M. Pawlik , Mina S. Makary , Ali Rikabi , Vineeth Sukrithan , Bhavana Konda , Jordan M. Cloyd

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引用次数: 0

摘要

局部疗法是治疗神经内分泌肝转移瘤（NELM）患者的主要方法，但最佳的经动脉方法仍未确定，最近的研究也引起了人们对经动脉化疗栓塞（TACE）安全性的担忧。我们对 2000-2022 年间在一家医疗机构接受 TACE 或经动脉栓塞（TAE）治疗的 NELM 患者进行了回顾性研究。采用倾向评分匹配法（PSM）对年龄、性别、双侧疾病、肿瘤大小、分叶栓塞、分级和肝外疾病进行控制，以比较短期和长期疗效。在412名NELM患者中，329人接受了TACE，83人接受了TAE。平均年龄为 60.7 ± 11.1 岁。患者主要表现为同步（69.2%）、双侧（84.2%）和G1疾病（48.8%），并接受了分期手术（55.8%）。PSM 术后，TACE 与稍差的术后实验室值相关，但并发症与 TAE 相比无差异（23.3%vs29.3%，P = 0.247）。TACE 与平均 PFS 的改善有关（21.8 个月vs10.7 个月，p = 0.002），但在放射学大小、嗜铬粒蛋白水平或中位总生存期（50.0 个月vs 未达标，p = 0.833）方面没有差异。在NELM患者中，与TAE相比，TACE与相似的短期疗效和改善的PFS相关，但在OS方面没有差异。这些发现凸显了对NELM最佳局部治疗进行更多研究的必要性。

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Trans-arterial embolization versus chemoembolization for neuroendocrine liver metastases: a propensity matched analysis

Introduction

Locoregional therapies are a mainstay of treatment for patients with neuroendocrine liver metastases (NELM), yet the optimal transarterial approach remains undefined and recent studies have raised concern over the safety of transarterial chemoembolization (TACE).

Methods

Patients with NELM who underwent TACE or transarterial embolization (TAE) at a single institution between 2000–2022 were retrospectively reviewed. Propensity score matching (PSM) controlling for age, sex, bilateral disease, tumor size, lobar embolization, grade, and extrahepatic disease was utilized to compare short- and long-term outcomes.

Results

Among 412 patients with NELM, 329 underwent TACE and 83 TAE. Mean age was 60.7 ± 11.1 years. Patients primarily presented with synchronous (69.2%), bilateral (84.2%), and G1 disease (48.8%) and underwent staged procedures (55.8%). Following PSM, TACE was associated with slightly worse post-procedure laboratory values, but no difference in complications compared to TAE (23.3%vs29.3%, p = 0.247). TACE was associated with improved mean PFS (21.8vs10.7 months, p = 0.002), but no difference in radiographic size, chromogranin level, or median overall survival (50.0 months vs not met, p = 0.833).

Conclusion

Among patients with NELM, TACE was associated with similar short-term outcomes and improved PFS, but no difference in OS compared to TAE. These findings highlight the need for additional research on the optimal locoregional therapy for NELM.

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来源期刊

Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.60

自引率

3.40%

发文量

244

审稿时长

57 days

期刊介绍： HPB is an international forum for clinical, scientific and educational communication. Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice. Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice. HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields. Abstracted and Indexed in: MEDLINE® EMBASE PubMed Science Citation Index Expanded Academic Search (EBSCO) HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).