TACE in colorectal liver metastases – different outcomes in right-sided and left-sided primary tumour location

Abstract

Purpose: This study investigated the oncologic outcome following transarterial chemoembolization (TACE) with irinotecan loaded spheres in patients with liver metastases of adenocarcinomas of right-, respectively left-sided colorectal origin (RSCC, LSCRC). Materials and methods: 21 Patients (pts) with unresectable monoor bilobar colorectal liver metastases (CRLM), liver-only or liver-dominant metastatic spread, with less than 25% of the liver parenchyma involved and progression after second line systemic chemotherapy underwent lobar irinotecan TACE. Tolerability, safety and oncologic outcome were assessed in terms of intervention-associated side effects, respectively local tumour control (LTC), progression free survival (PFS) and overall survival (mOS). Results: 16 pts with left-sided and 5 with right-sided colonic primary with a mean volumetric tumour burden of 5.27 ± 6.26%, median 2.89% (range 0.23 – 24.1%) received in total 49 TACE, in average 2.33 interventions per patient. Treatment-related abdominal pain occurred in 4.08% on the day of intervention and could sufficiently be controlled with pain medication on demand. LTC (CR, PR or SD) in the liver was achieved in 20/21 (95.2%), 19/21 (90.4%) and 16/21 (76.2%) patients at 1, 3 and 6 months, respectively. PFS was 5.5 mo in LSCRC, respectively 3.75 mo in RSCC. mOS was 33 mo after the first TACE in LSCRC, respectively 17 mo in RSCC. Conclusion: TACE with irinotecan loaded spheres is a safe and well tolerated procedure in the treatment of CRLM. The promising results in terms of mOS especially in tumours of left-sided origin deserve further investigation in larger prospective trials. *Correspondence to: Attila Kovács, Department of Diagnostic and Interventional Radiology and Neuroradiology, MediClin Robert Janker Klinik, Villenstraße 8, 53129 Bonn, Germany, Tel: +49 228 5306 – 501, Fax +49 228 5306 – 502, E-mail: attila.kovacs@mediclin.de