The Efficacy of Transcatheter Arterial Embolization in Renal Cell Carcinoma in Patients with a Poor Performance Status or at an Advanced Stage

Kim, Gun Nam; Kim, Bup Wan

Abstract

PURPOSE: To evaluate the efficacy of transcatheter arterial embolization (TAE) in patients with a renal cell carcinoma who were ineligible to undergo a nephrectomy due to their poor performance status and advanced stage.
MATERIALS AND METHODS
The study included 42 patients ineligible for a nephrectomy due to their poor performance status and advanced stage. The patients were classified into three groups; 13 patients with TAE for poor performance status (group A-1), 15 patients with TAE for advanced stage (group A-2) and 14 patients without TAE (group B). Group A-1 was composed of patients with a low stage and poor performance status, but there were no significant differences in the clinical factors between groups A-2 and B.
RESULTS
After TAE the tumor size became smaller in 19 cases, with the other 9 cases showing no response. TAE was more effective in group A-1 than A-2. The mean survivals of the three groups were 22 (A-1), 12.3 (A-2) and 4.8 months (B). In the A groups, 19 of the 28 patients were still alive, with a prolonged mean survival, which might due to the composition of group A-1, but group A-2 had a better mean survival than group B (p<0.001). Based on the above outcomes, those who underwent TAE had significantly better prognoses than those who did not. The adverse effects in the patients that underwent TAE included fever, back pain on the affected side, nausea and vomiting, but all the patients recovered from these adverse effects.
CONCLUSIONS
TAE, with Ivalon, is a safe and effective treatment for the patients who are unable to undergo nephrectomy due to their poor performance status and advanced stage. TAE not only induces ablasion of the primary tumor, but also prolongs the survival.