Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.
Surg Today. 2023 Dec;53(12):1396-1400. doi: 10.1007/s00595-023-02714-9. Epub 2023 Jun 24.
Transarterial chemoembolization (TACE) is performed for pancreatic neuroendocrine tumor (PanNEN) liver metastases; however, the safety and efficacy of TACE procedures, especially for patients who have undergone previous pancreatic surgery, have not been established. We reviewed 48 TACE procedures (1-6 procedures/patient) performed on 11 patients with PanNEN liver metastases, including 16 TACE procedures (4-6 procedures/patient) for 3 patients with a history of biliary-enteric anastomosis. The overall tumor objective response rate was 94%. The incidence of Clavien‒Dindo grade ≥ 2 complications was 1/16 (6%) and 1/32 (3%), and the median time to untreatable progression was 31 (14-41) and 27 (2-60) months among patients with and without a history of biliary-enteric anastomosis, respectively. Although validation is needed in future studies, our experiences have shown that TACE treatment is a viable treatment option for PanNEN liver metastases, even after biliary-enteric anastomosis with experienced teams and careful patient follow-up.
经动脉化疗栓塞术（TACE）用于治疗胰腺神经内分泌肿瘤（PanNEN）肝转移；然而，TACE 程序的安全性和疗效，特别是对于那些已经接受过胰腺手术的患者，尚未得到证实。我们回顾了 11 名 PanNEN 肝转移患者的 48 次 TACE 手术（1-6 次/患者），其中 3 名有胆肠吻合术史的患者接受了 16 次 TACE 手术（4-6 次/患者）。总体肿瘤客观缓解率为 94%。Clavien-Dindo 分级≥2 级并发症的发生率为 1/16（6%）和 1/32（3%），有胆肠吻合术史和无胆肠吻合术史的患者未治疗进展的中位时间分别为 31（14-41）个月和 27（2-60）个月。尽管需要在未来的研究中进行验证，但我们的经验表明，TACE 治疗是一种可行的治疗选择，即使在有经验的团队和仔细的患者随访下，也可以用于治疗有胆肠吻合术史的 PanNEN 肝转移。
