Efficacy of transcatheter arterial chemoembolization-based multimodal treatment in patients with neuroendocrine tumors involving the liver.

Background: Neuroendocrine tumors (NETs) are a group of heterogeneous diseases which have liver dominant involvement potency. The value of transcatheter arterial chemoembolization (TACE) treatment for NET patients in the era of somatostatin analogues (SSAs) and anti-proliferation agents needs further study. The study aimed to investigate the value of TACE-based treatment for NETs involving the liver.

Methods: A group of 29 NET patients received TACE-based multimodal treatment in the Department of Hepatic Oncology of Zhongshan Hospital, Fudan University was retrospectively collected. Baseline characteristics of included patients were analyzed. Kaplan-Meier analysis and Cox proportional hazards regression were used to investigate clinical and pathological parameters on overall survival (OS) and progression free-survival (PFS) in NET patients.

Results: The median OS and PFS were 20.0 [95% confidence interval (CI): 13.4-26.5] months and 11.0 (95% CI: 7.7-14.3) months, respectively. Tumor grade (P=0.001), number of TACE treatments (P=0.003), neutrophil to lymphocyte ratio (NLR) (P=0.005) and systemic treatment mode (P=0.007) were significantly associated with OS while tumor grade (P<0.001), number of TACE treatments (P=0.002), aspartate aminotransferase (AST) (P=0.01) and systemic treatment mode (P=0.001) were of significance to PFS in multivariate Cox regression analyses.

Conclusions: TACE-based multimodal treatment is beneficial for NETs involving the liver. The sequence and timing of local treatment and systemic treatment allocation need further investigation.