DSA manifestation in hepatic metastases from gastrointestinal cancer and its relation with short-term thera-peutic efficacy of transcatheter arterial chemoembolization

WANG Guoxiang; YANG Xiaohua; WANG Heping; HUANG Xinyu; YAN Xiaoxing; PEI Renguang; CHEN Fangman

Abstract：Objective To investigate the manifestation of digital subtract angiography( DSA) in hepatic metastases from as?trointestinal cancer and its relationship with the short?term efficacy of transcatheter arterial chemoembolization( TACE) . Methods 255 patients,who were in hospital with hepatic metastases from gastrointestinal cancer, were involved in the study. Primary tumors of these patients had been resected. Their pathology types were adenocarcinoma. All patients were given the hepatic trterial digital subtract angi?ography( DSA) before TACE. Based on the observation of the arterial blood supply in intrahepatic metastatic tumor,these blood supply were divided into the hypervascular pattern(n=34),the isovascular pattern(n=69) and the hypovascular pattern group(n=152) in order to investigate the relationship between the manifestation of hepatic metastases from gastrointestinal cancer and their short?term therapeutic efficacy of TACE. Results After TACE, the clinical effective rate( CR+PR) of hypervascular, isovascular and hypovascu?lar pattern group was 73?5%( 25/34) ,24?6%( 17/69) and 20?4%( 31/152) , respectively. A significant difference in short?term ther?apeutic efficacy existed between hypervascular and isovascular group as well as between hypervascular and hypovascular group ( P<0?01),while no significant difference existed between isovascular and hypovascular group(P>0?05). All patients appeared different degree of nausea, vomiting, liver area unwell or pain after TACE, there was no significant difference in 3 groups. No liver failure, seri?ous complications associated with interventional therapy were occured in all patients. Conclusion The main blood supply of hepatic metastases from gastrointestinal cancer is hypovascular pattern. Compared with isovascular and hypovascular tumor, TACE is much more effective in treating hypervascular patients suffering from hepatic metastases by gastrointestinal cancer. Non?vascular interventional therapy should be invited to treat isovascular and hypovascular tumors.