Comparison of TACE alone versus TACE combined with synchronous ablation for neuroendocrine neoplasms with liver metastases.

Objective: To compare the efficacy and safety between thermal ablation combined with synchronous TACE and TACE in patients with liver metastasis of neuroendocrine tumors of different pathologic grades and different primary sites.

Methods: A retrospective analysis was performed on patients with liver metastases of neuroendocrine tumors in this study. The patients were divided into simultaneous ablation group and TACE group according to treatment mode and subgroups. The endpoints of prognosis were progression-free survival (PFS) and overall survival (OS).

Results: A total of 108 patients with neuroendocrine tumors were collected, including 46 patients in the simultaneous ablation group and 62 patients in the TACE group. According to WHO classification, 21 patients with G1 grade, 55 patients with G2 grade and 32 patients with G3 grade were included. The median OS and the median PFS showed no statistically significant differences between the TACE group and the simultaneous ablation group. Among G2 stage, the TACE group and the synchronous ablation group showed no difference in the median OS but statistically difference in the median PFS. For G1&2 stage patients, synchronous ablation showed longer median PFS than TACE. In pNET patients, although median OS showed no significant difference between the two groups, the synchronous ablation group achieved longer median PFS compared to the TACE group. Both the TACE group and the synchronous ablation group showed improved median OS in G1&2 stage patients relative to G3 stage patients.

Conclusions: Simultaneous ablation can delay disease progression in patients with liver metastasis of neuroendocrine tumors to a certain extent, and has a good safety, especially for patients with liver metastases of neuroendocrine tumors of intermediate or low grade or pancreatic origin.