Transcatheter Arterial Chemoembolization for Liver Metastases in Patients with Adrenocortical Carcinoma

Purpose To retrospectively evaluate the effectiveness, tolerance, and predictors of response to transcatheter arterial chemoembolization for treatment of liver metastases from adrenocortical carcinoma. Materials and Methods Twenty-nine patients with progressive liver metastases from adrenocortical carcinoma were treated with transcatheter arterial chemoembolization. Rate and duration of tumor response were defined according to Response Evaluation Criteria In Solid Tumors. The size of liver metastases, percentage of liver involvement, and Lipiodol uptake were studied as potential predictive factors of response. Time to liver and metastatic lesion progression were considered as endpoints. Results Three months after transcatheter arterial chemoembolization, a liver morphologic response was observed in six of 29 patients (21%), stabilization in 18 (62%), and progression in five (17%). According to per-lesion analysis ( n = 103), a morphologic response was observed in 23 lesions (22%), stabilization in 67 (65%), and progression in 13 (13%). Higher response rates were observed in cases in which the diameter of the target metastasis was 3 cm or smaller ( P = .002) and in cases of high Lipiodol uptake (> 50%; P Conclusions Transcatheter arterial chemoembolization should be considered as part of the therapeutic arsenal to treat liver metastases from adrenocortical carcinoma. The size of liver metastases and the percentage of Lipiodol uptake may help identify patients likely to benefit most from transcatheter arterial chemoembolization.