Factors affecting periprocedural morbidity and mortality and long-term patient survival after arterial embolization of hepatic neuroendocrine metastases Journal Article
| Authors: | Sofocleous, C. T.; Petre, E. N.; Gonen, M.; Reidy-Lagunes, D.; Ip, I. K.; Alago, W.; Covey, A. M.; Erinjeri, J. P.; Brody, L. A.; Maybody, M.; Thornton, R. H.; Solomon, S. B.; Getrajdman, G. I.; Brown, K. T. |
| Article Title: | Factors affecting periprocedural morbidity and mortality and long-term patient survival after arterial embolization of hepatic neuroendocrine metastases |
| Abstract: | Purpose To identify factors affecting periprocedural morbidity and mortality and long-term survival following hepatic artery embolization (HAE) of hepatic neuroendocrine tumor (NET) metastases. Materials and Methods This single-center, institutional review board-approved retrospective review included 320 consecutive HAEs for NET metastases performed in 137 patients between September 1996 and September 2007. Forty-seven HAEs (15%) were performed urgently to manage refractory symptoms in inpatients (urgent group), and 273 HAEs (85%) were elective (elective group). Overall survival (OS) was estimated by Kaplan-Meier methodology. Complications were categorized per Common Terminology Criteria for Adverse Events, version 4.0. Univariate and multivariate analyses were performed to determine independent predictors for OS, complications, and 30-day mortality. The independent factors were combined to develop clinical risk score groups. Results Urgent HAE (P =.007), greater than 50% liver replacement by tumor (P <.0001), and extrahepatic metastasis (P =.007) were independent predictors for shorter OS. Patients with all three risk factors had decreased OS versus those with none (median, 8.5 vs 86 mo; P <.001). Thirty-day mortality was significantly lower in the elective (1%) versus the urgent group (8.5%; P =.0009). There were eight complications (3%) in the elective group and five (10.6%) in the urgent group (P =.03). Male sex and urgent group were independent factors for higher 30-day mortality rate (P =.023 and P =.016, respectively) and complications (P =.012 and P =.001, respectively). Conclusions Urgent HAE, replacement of more than 50% of liver by tumor, and extrahepatic metastasis are strong independent predictors of shorter OS. Male sex and urgent HAE carry higher 30-day mortality and periprocedural morbidity risks. © 2014 SIR. |
| Journal Title: | Journal of Vascular and Interventional Radiology |
| Volume: | 25 |
| Issue: | 1 |
| ISSN: | 1051-0443 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2014-01-01 |
| Start Page: | 22 |
| End Page: | 30 |
| Language: | English |
| DOI: | 10.1016/j.jvir.2013.09.013 |
| PROVIDER: | scopus |
| PUBMED: | 24365504 |
| DOI/URL: | |
| Notes: | Export Date: 2 April 2014 -- CODEN: JVIRE -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
Related MSK Work