Safety and efficacy outcomes of embolization in hepatic sarcomas

David B. Pierce, Guy E. Johnson, Eric Monroe, Elizabeth T. Loggers, Robin L. Jones, Seth M. Pollack, Siddharth A. Padia*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

OBJECTIVE. The outcome for patients with unresectable hepatic sarcoma is poor with a median survival period of 12–16 months. The purpose of this study was to evaluate liver-directed transcatheter therapies for the treatment of hepatic sarcomas. MATERIALS AND METHODS. In a retrospective study, the cases of patients with primary and metastatic hepatic sarcoma treated by transcatheter embolization, chemoembolization, and 90Y radioembolization between 2004 and 2015 were identified. Response Evaluation Criteria in Solid Tumors version 1.1 response was assessed for the target tumor. Survival was assessed by means of Kaplan-Meier analysis. RESULTS. Twenty-eight patients (17 [61%] men, 11 [39%] women; median age, 47 years) were included. Eighteen patients were treated electively. Two of the electively treated patients underwent embolization; eight, chemoembolization; six, radioembolization; and two, a combination of transcatheter treatments. Treatment was well tolerated; only one patient had grade 3 hepatic toxicity. The objective response rate of the index tumor was 61%, and the median overall survival period was 26.7 months. Ten patients underwent emergency embolization to control acute hemorrhage from tumor rupture. The median overall survival periods were 611 days for the patients with ruptured gastrointestinal stromal tumors (GIST) (n = 3) and 19 days for the patients with ruptured angiosarcoma (n = 7). CONCLUSION. Liver-directed transcatheter therapies are safe and may have a role in the elective management of unresectable primary and metastatic liver sarcomas. Emergency embolization for ruptured GIST may be effective for stabilizing the patient's condition and allowing more definitive therapy in the future. However, emergency embolization has limited efficacy in treating patients with ruptured angiosarcoma, likely because of substantial venous bleeding at rupture and the aggressive behavior of this lesion.

Original languageEnglish (US)
Pages (from-to)175-182
Number of pages8
JournalAmerican Journal of Roentgenology
Volume210
Issue number1
DOIs
StatePublished - Jan 2018
Externally publishedYes

Keywords

  • Chemoembolization
  • Liver
  • Radioembolization
  • Sarcoma

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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