Objective: We evaluated the effectiveness of transcatheter arterial chemoembolisation in patients with unresectable liver metastases.
Materials and methods: Between June 1999 and September 2005 chemoembolisation was performed in seven patients with no colorectal cancer metastases, 3 men and 4 women, average age 60 (range 59-68 years). Two patients had histologically confirmed metastases of adenocarcinoma of the stomach, three had metastases of unresectable gallblader adenocarcinoma and two had metastases adenocarcinoma of unknown primary. Chemoembolisation was performed selectively or superselectively with a suspension of Lipiodol®(8-15ml) and doxorubicine® 50mg. Chemoembolisation was followed by gelatin sponge embolisation in selected patients from this group. The total number of chemoembolisations was 16 in 7 patients.
Results: Median time to progression was 4 (2-27) months, median overall survival was 8 (2-29,4) months. No progression for more than 2 years has been observed in one patient with stomach cancer metastases.There was complete relief of symptoms in four symptomatic patients. There was a decrease a tumour marker serum concentration, to more than a half of initial concentration in 4 patients, which was associated with prolonged survival. These 4 patients showed high
saturation of Lipiodol® in metastatic lesions on CT scans, there was no progression of disease observed for 4, 9,11 and 27 months. Postchemoembolisation syndrome occurred in 2 patients and did not require prolonged hospital stay. All patients were treated with chemoembolisation only. Conclusions: Chemoembolisation is feasible and effective palliative treatment of liver metastases in patients who are not indicated for liver resection or systemic chemotherapy. Chemoembolistaion was more effective in patients who developed liver metastases long time after resection of the primary tumor. Predictive factors of response to treatment with TACE are Lipiodol® uptake in the metastases and decrease of tumour marker concentrations.