CC-BY-NC-ND 4.0 · J Clin Interv Radiol ISVIR 2018; 02(01): 003-012
DOI: 10.1055/s-0038-1609046
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

Tumor Vascularity Does Not Predict Response to Yttrium-90 Radioembolization for Hepatic Metastases from Colorectal Cancer

Alipi V. Naydenov
Department of Medicine, University of Washington, Seattle, Washington, United States
,
William P. Harris
Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, Washington, United States
,
Guy E. Johnson
Section of Interventional Radiology, Department of Radiology, University of Washington, Seattle, Washington, United States
,
Daniel S. Hippe
Department of Radiology, University of Washington, Seattle, Washington, United States
,
Siddharth A. Padia
Section of Interventional Radiology, Department of Radiology, David Geffen School of Medicine at University of California, Los Angeles, United States
› Author Affiliations
Further Information

Publication History

Received: 29 July 2017

Accepted: 29 September 2017

Publication Date:
03 May 2018 (online)

Abstract

The purpose of this study was to determine whether the degree of tumor vascularity based on imaging has an impact on tumor response and survival in patients with metastatic colorectal cancer (mCRC) to the liver undergoing yttrium-90 radioembolization. A retrospective study of 75 mCRC patients from a single-institution undergoing radioembolization was performed over a 7-year period. Tumors were categorized as hypo- or hypervascular based on digital subtraction angiography (DSA) and C-arm CT during mapping angiography. Tumor response and survival were compared between each group, after undergoing radioembolization. Hypervascular tumors were present in 37 of 75 (49%) patients according to DSA. Of 37 patients who underwent C-arm CT during the procedure, 22 (59%) had tumors classified as hypervascular. There were no significant differences in tumor response rates when vascularity was stratified by DSA or C-arm CT. Median progression-free survival (PFS) was 111 versus 128 days (p = 0.41) between DSA hypervascular and hypovascular cases, and median overall survival (OS) was 439 versus 342 days (p = 0.96). When stratified by C-arm CT, median PFS was 313 versus 244 days (p = 0.83) and median OS was 489 versus 342 days (p = 0.74) for hypervascular and hypovascular cases, respectively. Tumor vascularity based on DSA or C-arm CT does not predict imaging response or survival after radioembolization and should not be used as a criterion for selecting candidates for radioembolization for hepatic mCRC.