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Langenbeck's Archives of Surgery
Erschienen in: Langenbeck's Archives of Surgery 6/2015

01.08.2015 | Review Article

Transarterial chemoembolization (TACE) for colorectal liver metastases—current status and critical review

verfasst von: Alexander Massmann, Thomas Rodt, Steffen Marquardt, Roland Seidel, Katrina Thomas, Frank Wacker, Götz M. Richter, Hans U. Kauczor, Arno Bücker, Philippe L. Pereira, Christof M. Sommer

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 6/2015

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Abstract

Background

Transarterial liver-directed therapies are currently not recommended as a standard treatment for colorectal liver metastases. Transarterial chemoembolization (TACE), however, is increasingly used for patients with liver-dominant colorectal metastases after failure of surgery or systemic chemotherapy. The limited available data potentially reveals TACE as a valuable option for pre- and post-operative downsizing, minimizing time-to-surgery, and prolongation of overall survival after surgery in patients with colorectal liver only metastases.

Purpose

In this overview, the current status of TACE for the treatment of liver-dominant colorectal liver metastases is presented. Critical comments on its rationale, technical success, complications, toxicity, and side effects as well as oncologic outcomes are discussed. The role of TACE as a valuable adjunct to surgery is addressed regarding pre- and post-operative downsizing, conversion to resectability as well as improvement of the recurrence rate after potentially curative liver resection. Additionally, the concept of TACE for liver-dominant metastatic disease with a focus on new embolization technologies is outlined.

Conclusions

There is encouraging data with regard to technical success, safety, and oncologic efficacy of TACE for colorectal liver metastases. The majority of studies are non-randomized single-center series mostly after failure of systemic therapies in the 2nd line and beyond. Emerging techniques including embolization with calibrated microspheres, with or without additional cytotoxic drugs, degradable starch microspheres, and technical innovations, e.g., cone-beam computed tomography (CT) allow a new highly standardized TACE procedure. The real efficacy of TACE for colorectal liver metastases in a neoadjuvant, adjuvant, and palliative setting has now to be evaluated in prospective randomized controlled trials.
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Metadaten
Titel
Transarterial chemoembolization (TACE) for colorectal liver metastases—current status and critical review
verfasst von
Alexander Massmann
Thomas Rodt
Steffen Marquardt
Roland Seidel
Katrina Thomas
Frank Wacker
Götz M. Richter
Hans U. Kauczor
Arno Bücker
Philippe L. Pereira
Christof M. Sommer
Publikationsdatum
01.08.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Langenbeck's Archives of Surgery / Ausgabe 6/2015
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-015-1308-9

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