Background/aims: We investigated whether tumor hypervascularity in diagnostic images predicts response to transcatheter arterial embolization in colorectal liver metastases.
Methodology: Forty-five patients undergoing transcatheter arterial embolization for liver metastases were grouped by tumor vascularity on contrast-enhanced computed tomography and angiography. Group IA (n = 10) included patients with hypervascular tumors by both contrast-enhanced computed tomography and early-phase angiography; group IB (n = 15), hypervascularity by contrast-enhanced computed tomography and only late-phase angiography; group IIB (n = 2), hypovascularity by contrast-enhanced computed tomography and only early-phase angiography; group IIC (n = 18), hypovascularity by contrast-enhanced computed tomography and both angiography phases (unmentioned groups included no patients). Tumor response assessed by computed tomography and changes in serum carcinoembryonic antigen concentration at 1 month, as well as survival rates, were compared between groups.
Results: Patients with a partial response numbered only 5, all in group IA. Patients with no change included 26 (group IA, 4; group IB, 10; group IIB, 1; group IIC, 11), while patients with progressive disease numbered 14 (group IA, 1; group IB, 5; group IIB, 1; group IIC, 7). Serum carcinoembryonic antigen concentrations were 0.62, 1.03, 1.31, and 2.01% of pretreatment rates in groups IA, IB, IIB, and IIC, respectively. Carcinoembryonic antigen increases in group IA plus IB were significantly lower (P = 0.04) than in group IIB plus IIC. The decreases in group IA differed significantly from changes in group IB plus IIB (P = 0.05), or group IIC (P = 0.02). Survival rates were somewhat higher group IA than in other, but not significantly.
Conclusions: Transcatheter arterial embolization is effective against colorectal liver metastases only when hypervascularity is evident.
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