Treatment of metastatic sarcoma to the liver with bland embolization

Mary Maluccio, Anne M. Covey, Johanna Schubert, Lynn A. Brody, Constantinos T. Sofocleous, George I. Getrajdman, Ronald DeMatteo, Karen T. Brown

Research output: Contribution to journalArticle

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Abstract

BACKGROUND. The authors evaluated the impact of bland particle embolization on survival in patients with metastatic sarcoma to the liver. METHODS. Twenty-four patients with liver-dominant metastases from sarcoma were treated with particle embolization from 1996 to 2002. Primary tumors included 16 gastrointestinal stromal tumors (GISTs), 7 intestinal leiomyosarcomas, and 1 liposarcoma. Thirteen patients had known extrahepatic disease. Embolization was performed by using polyvinyl alcohol or trisacryl microspheres to effect stasis in the target vessel(s). Follow-up images to assess response were obtained 4 weeks after the procedure. Decrease in the size of the target lesion by >25% or development of >50% necrosis on follow-up imaging was considered a treatment response. RESULTS. Nineteen patients had metachronous liver metastases, and the median disease-free interval was 22 months (range 10-156 months) from resection of the primary tumor. Ten patients underwent prior liver resection for metastatic disease. Of 15 evaluable patients, 9 patients (60%) had a radiographic response. The median follow-up for all patients was 21 months. The median follow-up for surviving patients was 59 months. Overall survival from the time of initial embolization was 62% at 1 year, 41% at 2 years, and 29% at 3 years. Patients who had radiographic evidence of response survived significantly longer than patients who did not respond (63 months vs. 19 months; P < .007). Patients with GIST survived significantly longer than patients with visceral leiomyosarcoma (median, 36 months vs. 18 months; P < .03). CONCLUSIONS. Bland embolization was efficacious in some patients with metastatic sarcoma to the liver. Radiographic evidence of response was correlated with improved survival. This regional therapy may enter the treatment algorithm for patients who have unresectable disease or disease that has failed conventional therapies.

Original languageEnglish
Pages (from-to)1617-1623
Number of pages7
JournalCancer
Volume107
Issue number7
DOIs
StatePublished - Oct 1 2006

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Sarcoma
Liver
Therapeutics
Gastrointestinal Stromal Tumors
Leiomyosarcoma
Survival
Neoplasm Metastasis
Polyvinyl Alcohol
Liposarcoma
Microspheres
Neoplasms
Necrosis

Keywords

  • Embolization
  • Gastrointestinal stromal tumors
  • Sarcoma
  • Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Maluccio, M., Covey, A. M., Schubert, J., Brody, L. A., Sofocleous, C. T., Getrajdman, G. I., ... Brown, K. T. (2006). Treatment of metastatic sarcoma to the liver with bland embolization. Cancer, 107(7), 1617-1623. https://doi.org/10.1002/cncr.22191

Treatment of metastatic sarcoma to the liver with bland embolization. / Maluccio, Mary; Covey, Anne M.; Schubert, Johanna; Brody, Lynn A.; Sofocleous, Constantinos T.; Getrajdman, George I.; DeMatteo, Ronald; Brown, Karen T.

In: Cancer, Vol. 107, No. 7, 01.10.2006, p. 1617-1623.

Research output: Contribution to journalArticle

Maluccio, M, Covey, AM, Schubert, J, Brody, LA, Sofocleous, CT, Getrajdman, GI, DeMatteo, R & Brown, KT 2006, 'Treatment of metastatic sarcoma to the liver with bland embolization', Cancer, vol. 107, no. 7, pp. 1617-1623. https://doi.org/10.1002/cncr.22191
Maluccio M, Covey AM, Schubert J, Brody LA, Sofocleous CT, Getrajdman GI et al. Treatment of metastatic sarcoma to the liver with bland embolization. Cancer. 2006 Oct 1;107(7):1617-1623. https://doi.org/10.1002/cncr.22191
Maluccio, Mary ; Covey, Anne M. ; Schubert, Johanna ; Brody, Lynn A. ; Sofocleous, Constantinos T. ; Getrajdman, George I. ; DeMatteo, Ronald ; Brown, Karen T. / Treatment of metastatic sarcoma to the liver with bland embolization. In: Cancer. 2006 ; Vol. 107, No. 7. pp. 1617-1623.
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abstract = "BACKGROUND. The authors evaluated the impact of bland particle embolization on survival in patients with metastatic sarcoma to the liver. METHODS. Twenty-four patients with liver-dominant metastases from sarcoma were treated with particle embolization from 1996 to 2002. Primary tumors included 16 gastrointestinal stromal tumors (GISTs), 7 intestinal leiomyosarcomas, and 1 liposarcoma. Thirteen patients had known extrahepatic disease. Embolization was performed by using polyvinyl alcohol or trisacryl microspheres to effect stasis in the target vessel(s). Follow-up images to assess response were obtained 4 weeks after the procedure. Decrease in the size of the target lesion by >25{\%} or development of >50{\%} necrosis on follow-up imaging was considered a treatment response. RESULTS. Nineteen patients had metachronous liver metastases, and the median disease-free interval was 22 months (range 10-156 months) from resection of the primary tumor. Ten patients underwent prior liver resection for metastatic disease. Of 15 evaluable patients, 9 patients (60{\%}) had a radiographic response. The median follow-up for all patients was 21 months. The median follow-up for surviving patients was 59 months. Overall survival from the time of initial embolization was 62{\%} at 1 year, 41{\%} at 2 years, and 29{\%} at 3 years. Patients who had radiographic evidence of response survived significantly longer than patients who did not respond (63 months vs. 19 months; P < .007). Patients with GIST survived significantly longer than patients with visceral leiomyosarcoma (median, 36 months vs. 18 months; P < .03). CONCLUSIONS. Bland embolization was efficacious in some patients with metastatic sarcoma to the liver. Radiographic evidence of response was correlated with improved survival. This regional therapy may enter the treatment algorithm for patients who have unresectable disease or disease that has failed conventional therapies.",
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AU - Getrajdman, George I.

AU - DeMatteo, Ronald

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N2 - BACKGROUND. The authors evaluated the impact of bland particle embolization on survival in patients with metastatic sarcoma to the liver. METHODS. Twenty-four patients with liver-dominant metastases from sarcoma were treated with particle embolization from 1996 to 2002. Primary tumors included 16 gastrointestinal stromal tumors (GISTs), 7 intestinal leiomyosarcomas, and 1 liposarcoma. Thirteen patients had known extrahepatic disease. Embolization was performed by using polyvinyl alcohol or trisacryl microspheres to effect stasis in the target vessel(s). Follow-up images to assess response were obtained 4 weeks after the procedure. Decrease in the size of the target lesion by >25% or development of >50% necrosis on follow-up imaging was considered a treatment response. RESULTS. Nineteen patients had metachronous liver metastases, and the median disease-free interval was 22 months (range 10-156 months) from resection of the primary tumor. Ten patients underwent prior liver resection for metastatic disease. Of 15 evaluable patients, 9 patients (60%) had a radiographic response. The median follow-up for all patients was 21 months. The median follow-up for surviving patients was 59 months. Overall survival from the time of initial embolization was 62% at 1 year, 41% at 2 years, and 29% at 3 years. Patients who had radiographic evidence of response survived significantly longer than patients who did not respond (63 months vs. 19 months; P < .007). Patients with GIST survived significantly longer than patients with visceral leiomyosarcoma (median, 36 months vs. 18 months; P < .03). CONCLUSIONS. Bland embolization was efficacious in some patients with metastatic sarcoma to the liver. Radiographic evidence of response was correlated with improved survival. This regional therapy may enter the treatment algorithm for patients who have unresectable disease or disease that has failed conventional therapies.

AB - BACKGROUND. The authors evaluated the impact of bland particle embolization on survival in patients with metastatic sarcoma to the liver. METHODS. Twenty-four patients with liver-dominant metastases from sarcoma were treated with particle embolization from 1996 to 2002. Primary tumors included 16 gastrointestinal stromal tumors (GISTs), 7 intestinal leiomyosarcomas, and 1 liposarcoma. Thirteen patients had known extrahepatic disease. Embolization was performed by using polyvinyl alcohol or trisacryl microspheres to effect stasis in the target vessel(s). Follow-up images to assess response were obtained 4 weeks after the procedure. Decrease in the size of the target lesion by >25% or development of >50% necrosis on follow-up imaging was considered a treatment response. RESULTS. Nineteen patients had metachronous liver metastases, and the median disease-free interval was 22 months (range 10-156 months) from resection of the primary tumor. Ten patients underwent prior liver resection for metastatic disease. Of 15 evaluable patients, 9 patients (60%) had a radiographic response. The median follow-up for all patients was 21 months. The median follow-up for surviving patients was 59 months. Overall survival from the time of initial embolization was 62% at 1 year, 41% at 2 years, and 29% at 3 years. Patients who had radiographic evidence of response survived significantly longer than patients who did not respond (63 months vs. 19 months; P < .007). Patients with GIST survived significantly longer than patients with visceral leiomyosarcoma (median, 36 months vs. 18 months; P < .03). CONCLUSIONS. Bland embolization was efficacious in some patients with metastatic sarcoma to the liver. Radiographic evidence of response was correlated with improved survival. This regional therapy may enter the treatment algorithm for patients who have unresectable disease or disease that has failed conventional therapies.

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