Original Investigation|Articles in Press

Clinical Outcomes of DEB-TACE in Hepatic Metastatic Neuroendocrine Tumors: A 5-Year Single-Institutional Experience

Published:April 25, 2023DOI:

      Rationale and Objectives

      To evaluate single-institution outcomes of drug-eluting bead transarterial chemoembolization (DEB-TACE) in the treatment of locally advanced neuroendocrine tumor (NET) hepatic metastases with a focus on safety and efficacy of treatment.

      Materials and Methods

      A single-center retrospective cohort study of the outcomes of consecutive patients with NELM who underwent DEB-TACE between 2014 and 2019 was performed. Clinicopathologic characteristics, radiologic response (modified Response Evaluation Criteria in Solid Tumors) at 1-month follow-up, adverse events, progression-free survival (PFS), and overall survival were calculated.


      Among 287 patients (mean age of 62 years; 39% male: 61% female), disease burden was bilobar (90.2%) with mean largest tumor diameter measuring 4.9 ± 2.8 cm. Of these patients, 14.6% had no evidence of tumor in other organs or lymph nodes. Complete response occurred in 60 (20.9%) patients while 133 (46.3%) had partial responses. Major complication occurred in 2.4%. Liver function tests including total bilirubin and AST were overall stable at the 1-month follow-up, with only a small increase in the ALT at +8.9% (p < 0.01). Overall survival was 80.1% at 1 year, 49.1% at 3 years, and 12.3% at 5 years with a mean PFS of 14.4 ± 12.5 months.


      Based on this institutional experience, DEB-TACE is an acceptable locoregional therapy choice for hepatic metastases of NET due to its tolerable safety profile and relative efficacy.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Academic Radiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Williams E.D.
        • Sandler M.
        The classification of carcinoid tumours.
        Lancet Oncol. 1963; 1: 238-239
        • Sorbye H.
        • Strosberg J.
        • Baudin E.
        • et al.
        Gastroenteropancreatic high-grade neuroendocrine carcinoma.
        Cancer. 2014; 120: 2814-2823
        • Frilling A.
        • Modlin I.M.
        • Kidd M.
        • et al.
        Recommendations for management of patients with neuroendocrine liver metastases.
        Lancet Oncol. 2014; 15: e8-e21
        • Zane K.E.
        • Cloyd J.M.
        • Mumtaz K.S.
        • et al.
        Metastatic disease to the liver: locoregional therapy strategies and outcomes.
        World J Clin Oncol. 2021; 12: 725-745
        • Orgera G.
        • Krokidis M.
        • Cappucci M.
        • et al.
        Current status of interventional radiology in the management of gastro-entero-pancreatic neuroendocrine tumours (GEP-NETs).
        Cardiovasc Intervent Radiol. 2015; 38: 13-24
        • Ta E.
        • Kennedy S.
        • Farrell A.
        • et al.
        Comparison of transarterial bland and chemoembolization for neuroendocrine tumours: a systematic review and meta-analysis.
        Curr Oncol. 2020; 27: e537-e546
        • Song J.E.
        • Kim D.Y.
        Conventional vs drug-eluting beads transarterial chemoembolization for hepatocellular carcinoma.
        World J Hepatol. 2017; 9: 808-814
        • Soulen M.
        • White S.
        • Fidelman N.
        • et al.
        Randomized Embolization Trial for NeuroEndocrine Tumors (RETNET): first safety report.
        J Vasc Interv Radiol. 2019; 30: S49-S50
        • Lencioni R.
        • Llovet J.M.
        Modified RECIST (mRECIST) assessment for hepatocellular carcinoma.
        Semin Liver Dis. 2010; 30: 52-60
        • Khalilzadeh O.
        • Baerlocher M.O.
        • Shyn P.B.
        • et al.
        Proposal of a new adverse event classification by the Society of Interventional Radiology Standards of Practice Committee [published correction appears in J Vasc Interv Radiol. 2018 Jan;29(1):146].
        J Vasc Interv Radiol. 2017; 28: 1432-1437.e3
        • Cloyd J.M.
        • Ejaz A.
        • Konda B.
        • et al.
        Neuroendocrine liver metastases: a contemporary review of treatment strategies.
        Hepatobiliary Surg Nutr. 2020; 9: 440-451
        • Makary M.S.
        • Kapke J.
        • Yildiz V.
        • et al.
        Conventional versus drug-eluting bead transarterial chemoembolization for neuroendocrine tumor liver metastases.
        J Vasc Interv Radiol. 2016; 27: 1298-1304
        • De Mestie L.
        • Zappa M.
        • Hentic O.
        • et al.
        Liver transarterial embolizations in metastatic neuroendocrine tumors.
        Rev Endocr Metab Disord. 2017; 18: 459-471
        • Okuyama H.
        • Ikeda M.
        • Takahashi H.
        • et al.
        Transarterial (chemo)embolization for liver metastases in patients with neuroendocrine tumors.
        Oncology. 2017; 92 (Epub 2017 Mar 23): 353-359
        • Salem R.
        • Lewandowski R.J.
        • Mulcahy M.F.
        • et al.
        Radioembolization for hepatocellular carcinoma using Yttrium-90 microspheres: a comprehensive report of long-term outcomes.
        Gastroenterology. 2010; 138: 52-64
        • Egger M.E.
        • Armstrong E.
        • Martin 2nd, R.C.
        • et al.
        Transarterial chemoembolization vs radioembolization for neuroendocrine liver metastases: a multi-institutional analysis.
        J Am Coll Surg. 2020; 230 (Epub 2020 Feb 4): 363-370