Defining predictors for long progression-free survival after radioembolisation of hepatic metastases of neuroendocrine origin.
Objectives: To define predictive parameters of long progression-free survival (PFS) in patients undergoing radioembolisation of neuroendocrine liver metastases.Methods: The following clinical and magnetic resonance imaging (MRI) parameters of 45 radioembolised patients (median age, 62 years; range,...
| Publicado en: | European Radiology Vol. 23; no. 11; pp. 3094 - 3104 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Nov2013
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104103283&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104103283 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Nov2013 vid: 23 iid: 11 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104103283 NLM23807569 2012337703 10.1007/s00330-013-2925-8 NLM23807569 104103283 ppf: 3094 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Defining predictors for long progression-free survival after radioembolisation of hepatic metastases of neuroendocrine origin. aug: au: Sommer, Wieland H Ceelen, Felix García-Albéniz, Xabier Paprottka, Philipp M Auernhammer, Christoph J Armbruster, Marco Nikolaou, Konstantin Haug, Alexander R Reiser, Maximilian F Theisen, Daniel affil: Department of Clinical Radiology, University Hospitals-Grosshadern, Ludwig-Maximilians University, Munich, Germany, wieland.sommer@med.uni-muenchen.de. sug: subj: Antineoplastic Agents Therapeutic Use Liver Neoplasms Therapy Magnetic Resonance Imaging Methods Neuroendocrine Tumors Therapy Adult Aged Chemoembolization, Therapeutic Methods Prognosis Female Prospective Studies Human Liver Neoplasms Diagnosis Liver Neoplasms Male Latex Middle Age Neuroendocrine Tumors Diagnosis Neuroendocrine Tumors Retrospective Design Treatment Outcomes Adult: 19-44 years Aged: 65+ years Middle Aged: 45-64 years Female Male ab: Objectives: To define predictive parameters of long progression-free survival (PFS) in patients undergoing radioembolisation of neuroendocrine liver metastases.Methods: The following clinical and magnetic resonance imaging (MRI) parameters of 45 radioembolised patients (median age, 62 years; range, 43-75) were reviewed: age, gender, levels of chromogranin A and neuron-specific enolase (NSE), primary tumour site, Ki-67 proliferation index, hepatic tumour load, number of metastases, signal intensity characteristics, vascularisation, haemorrhagic and necrotic transformation and fluid-fluid levels. PFS was assessed according to RECIST 1.0. Statistical analysis included univariate Cox regression, Kaplan-Meier and multivariate regression.Results: Median PFS was 727 days (95 % CI, 378-964). In the univariate regression analysis, hypovascular metastases progressed earlier (111 vs 727 days; P < 0.05). A Ki-67 ≤2 % was associated with a longer PFS than a Ki-67 of 3-20 % or >20 % (911 vs 727 vs 210 days, respectively; P < 0.05). Low NSE predicted longer PFS (911 vs 378 days; P < 0.05). In the adjusted multivariate analysis, vascularisation (hypervascularisation vs. no hypervascularisation; P = 0.0009) and NSE level (low vs high; P = 0.0119) had the strongest influence on PFS.Conclusion: Response to radioembolisation in patients with neuroendocrine liver metastases can be predicted by the metastatic vascularisation pattern, the NSE level and the Ki-67.Key Points: • Radioembolisation is an effective treatment in hepatic metastases of neuroendocrine origin. • Pre-therapeutic vascularisation patterns of metastases on MRI can predict long progression-free survival. • Assessment of pre-therapeutic markers provides better therapy planning. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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