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30.07.2024 | Interventional

Safety and efficacy of percutaneous arterial port Implantation for Hepatic Arterial Infusion Chemotherapy

verfasst von: Louis Meyblum, Matthieu Faron, Frédéric Deschamps, Adrian Kobe, Baptiste Bonnet, Alice Boileve, Maximilliano Gelli, Valérie Boige, Antoine Hollebecque, Jerome Durand-Labrunie, David Malka, Remy Barbé, Michel Ducreux, Thierry de Baere, Lambros Tselikas

Erschienen in: European Radiology | Ausgabe 2/2025

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Abstract

Objectives

Approximately 40% of patients with colorectal cancer will develop liver metastases. Hepatic arterial infusion chemotherapy (HAIC) represents a valuable treatment option, with curative, palliative, or adjuvant intent. The aim of our study was to describe technical considerations, safety, and oncological outcomes of patients receiving HAIC.

Materials and methods

All patients who underwent percutaneous hepatic arterial port placement in our institution between 2004 and 2021 were included in this retrospective analysis. Demographic, anatomical and technical data were collected. Tumor response was assessed using RECIST 1.1. Kaplan-Meier estimates were used for overall survival (OS) and hepatic progression-free survival (PFS). Adverse events (AEs) were graded using the Clavien-Dindo classification.

Results

A total of 360 patients (median age, 58.6 years [interquartile range (IQR): 49.5–65.4]; 208 men [57.8%]) were included. Percutaneous hepatic arterial port placement was successful in 87.9% of cases, resulting in 379 port placements (431 attempts). Overall, 394 HAIC courses were delivered, mostly oxaliplatin-based (94.7%), with a median of 6 cycles per course (IQR: 3–8). AEs (all grades) were observed in 42.0% of ports (grade IIIb-V: 1.1%). Most port dysfunctions could be resolved, resulting in a 73.1% rate of HAIC resumption, without impact on OS. Median OS was 22 months (IQR: 18–24), and median hepatic PFS was 11 months (IQR: 9.5–13). Tumor downstaging allowed surgery in 35.6% of patients, with significantly longer median OS than non-operated patients (39 months [IQR: 33–79] versus 14 months [IQR: 12–16], p < 0.001).

Conclusion

This retrospective cohort study demonstrates the feasibility, safety, and efficacy of percutaneous hepatic arterial port placement with an impact on survival for selected patients.

Clinical relevance statement

Percutaneous hepatic arterial port placement is feasible, safe and effective with an impact on the survival of selected patients.

Key Points

Hepatic arterial infusion chemotherapy provides promising tumor response and overall survival, especially in cases of resection/ablation.
Total complication rate of hepatic arterial infusion chemotherapy port use is high, but serious complications are rare.
Port revision is often necessary but allows the resumption of hepatic arterial infusion chemotherapy without affecting overall survival.

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Titel: Safety and efficacy of percutaneous arterial port Implantation for Hepatic Arterial Infusion Chemotherapy
verfasst von: Louis Meyblum
Matthieu Faron
Frédéric Deschamps
Adrian Kobe
Baptiste Bonnet
Alice Boileve
Maximilliano Gelli
Valérie Boige
Antoine Hollebecque
Jerome Durand-Labrunie
David Malka
Remy Barbé
Michel Ducreux
Thierry de Baere
Lambros Tselikas
Publikationsdatum: 30.07.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 2/2025
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-024-10887-1

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Safety and efficacy of percutaneous arterial port Implantation for Hepatic Arterial Infusion Chemotherapy