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Introduction. The liver is a common site of metastasis for neuroendocrine tumors (NET). The number, size, and distribution of liver metastases are important factors that influence the prognosis and quality of life of patients.
Until recently, surgical resection was the preferred treatment method. However, due to the multifocal and predominantly bilobar nature of liver involvement in NET metastases, many patients with NET metastases are not eligible for surgical intervention.
Aim. To analyze the results of intra-arterial chemioembolization in treating patients with unresectable liver metastases of NET.
Materials and methods. We conducted a retrospective evaluation of treatment outcomes using interventional radiology methods for 142 patients with liver metastases of NET between 2006 and 2021.
Results. After two cycles of regional chemotherapy, a complete response was achieved in 13 % of patients, partial response in 20 %, stabilization in 53 %, and progression in 14 %. Reduction of carcinoid syndrome symptoms was observed in 65 % of patients. In patients with primary unresectable NET liver metastases after regional chemotherapy, radical surgery was possible in 5 % of cases and cytoreductive surgery in 8 % of cases.
Conclusion. The number, size, and location of liver metastases are important factors determining the disease prognosis and the patient's quality of life. Given the multifocal, predominantly bilobar nature of liver involvement, the majority of patients with NET metastases are not suitable for surgery. Interventional radiology methods are an effective alternative treatment that can reduce tumor burden, alleviate symptomatic manifestations of carcinoid syndrome, and prepare the patient for further cytoreductive interventions.
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