Prognostic factors for the effectiveness of transarterial chemoembolization in patients with secondary liver tumors

Objective. To evaluate the prognostic factors for the effectiveness of transarterial chemoembolization (TACE) with drug-eluting beads in patients with liver metastases from colorectal cancer (CRC), breast cancer (BC), pancreatic cancer (PC), and gastric cancer (GC). Material and methods. A retrospective study included 64 patients with liver metastases who underwent 98 TACE procedures. Treatment response was assessed according to RECIST 1.1 criteria 6—8 weeks after the procedure. Univariate and multivariate logistic regression analyses were performed to identify factors associated with the objective response rate (ORR). Results. The overall ORR was 48.4% (95% CI: 36.2—60.7%), and the disease control rate (DCR) was 76.5% (95% CI: 65.0—85.0%). The highest efficacy was observed in metastases from BC (ORR 57.1%) and CRC (ORR 50.0%), the lowest — in PC (ORR 30.0%) (p<0.05). Multivariate analysis identified the size of metastatic lesions less than 5 cm (aOR=2.90; 95% CI: 1.11—7.60; p=0.03) and the absence of extrahepatic metastases (aOR=2.60; 95% CI: 1.05—6.70; p=0.04) as independent positive prognostic factors for TACE effectiveness. Conclusion. TACE is an effective method for controlling secondary liver tumors. Metastasis size <5 cm and the absence of extrahepatic spread are key independent prognostic factors for TACE success and can be used to optimize patient selection.