Predicting Mean Survival Time from Reported Median Survival Time for Cancer Patients

Background: Mean duration of survival following treatment is a prerequisite for cost-effectiveness analyses used for assessing new and costly life-extending therapies for cancer patients. Mean survival time is rarely reported due to censoring imposed by limited follow-up time, whereas the median survival time often is. The empirical relationship between mean and median survival time for cancer patients is not known. Aim: To derive the empirical associations between mean and median survival time across cancer types and to validate this empirical prediction approach and compare it with the standard approach of fitting a Weibull distribution. Methods: We included all patients in Norway diagnosed from 1960 to 1999 with one of the 13 most common solid tumor cancers until emigration, death, or 31 December 2011, whichever came first. Observed median, restricted mean, and mean survival times were obtained in subcohorts defined by patients’ sex, age, cancer type, and time period of diagnosis, which had nearly complete follow-up. Based on theoretical considerations, we fitted a linear relationship between observed means and medians on the log scale. For validation, we estimated mean survival from medians of bootstrap samples with artificially induced censoring and compared with fitting a Weibull distribution. Results: A linear relationship between log-mean survival time and log-median survival time was identified for the 6 cancers with shortest survival plus metastasized breast and prostate cancers. The predicted means of the empirical approach had smaller bias than the standard Weibull approach. Conclusion: For cancer diagnoses with poor prognosis, mean survival times could be predicted from corresponding medians. This empirical prediction approach is useful for validation of estimates of mean survival time and sensitivity analyses in settings with aggregated data only.

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Effect of Hemoglobin on the Prognosis of Patients with Advanced Cancer in Palliative Care Settings

10.21203/rs.3.rs-850589/v1 ◽

2021 ◽

Author(s):

xinghe liao ◽

Cihang Bao ◽

Minghui Liu ◽

Menglei Chen ◽

Xiaoli Gu ◽

...

Keyword(s):

Survival Time ◽

Cancer Patients ◽

Advanced Cancer ◽

Median Survival ◽

Median Survival Time ◽

Palliative Treatment ◽

Treatment Center ◽

Cancer Center ◽

Advanced Cancer Patients

Abstract Background: Hemoglobin is a prognostic factor for many cancer patients. However, its effect on the prognosis of patients with advanced cancer receiving palliative treatment is still unclear.Objective: The aim of this study was to assess whether hemoglobin can be used as a prognostic indicator for patients with advanced cancer receiving palliative treatment.Methods: From July 2013 to October 2015, 368 consecutive patients were treated in the palliative treatment center of the Shanghai Cancer Center of Fudan University. The data for 105 patients were extended in the follow-up. The cut-off value selected for hemoglobin was 100 g/L.Results: The median survival time of patients with low hemoglobin was shorter than that of patients with high hemoglobin (41 days vs. 84 days). In the follow-up readmission cohort (n = 105), the median survival time for patients with high hemoglobin (HHb → HHb) was 3.44 times longer than that of patients with low hemoglobin (HHb → LHb). Thus, both low hemoglobin and decreased hemoglobin were identified as independent prognostic factors for poor prognosis.Conclusions: In palliative treatment, hemoglobin can be used as a stratification factor to determine the prognosis of advanced cancer patients.

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Predicting Difference in Mean Survival Time from Reported Hazard Ratios for Cancer Patients

Medical Decision Making ◽

10.1177/0272989x19832879 ◽

2019 ◽

Vol 39 (3) ◽

pp. 228-238 ◽

Cited By ~ 2

Author(s):

Eeva-Liisa Røssell Johansen ◽

Mette Lise Lousdal ◽

Mette Vinther Skriver ◽

Michael Væth ◽

Ivar Sønbø Kristiansen ◽

...

Keyword(s):

Survival Time ◽

Cancer Patients ◽

Empirical Relationship ◽

Hazard Ratio ◽

Cancer Type ◽

Survival Times ◽

Mean Survival Time ◽

Hazard Ratios ◽

Weibull Models

Background. Gain in mean survival time from new cancer treatments is a core component of cost-effectiveness analyses frequently used by payers for reimbursement decisions. Due to limited follow-up time, clinical trials rarely report this measure, whereas they often report hazard ratios comparing treatment groups. Aim. We aimed to explore the empirical relationship between gain in mean survival time and the hazard ratio for cancer patients. Methods. We included all patients in Norway diagnosed from 1965 through 2004 with late-stage cancer at the point of diagnosis and with one of the following cancers: stomach, colon, rectal, pancreas, lung and trachea, kidney excluding renal pelvis, and metastasized breast and prostate. Patients were followed until emigration, death, or June 30, 2016, whichever came first. Observed mean survival times and hazard ratios were obtained in subcohorts defined by patients’ sex, age, cancer type, and time period of diagnosis, which had nearly complete follow-up. Based on theoretical considerations, we fitted a linear relationship between observed differences in mean survival and logarithmic hazard ratios. For validation, we estimated differences in mean survival from hazard ratios of bootstrap samples with artificially induced censoring and compared with fitting a Weibull distribution. Results. The relationship between differences in mean survival time and corresponding logarithmic hazard ratios was linear for each of the included cancers. The predicted differences in mean survival of the empirical approach generally had smaller bias than the Weibull approach. Conclusion. For cancer diagnoses with poor prognosis, differences in mean survival times could be predicted from corresponding hazard ratios. This hazard ratio–based approach outperforms or is similar to fitting Weibull models to data with incomplete follow-up, while making fewer assumptions.

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3217 Catatonia, Delirium and Coma: Implications for Mortality

Journal of Clinical and Translational Science ◽

10.1017/cts.2019.91 ◽

2019 ◽

Vol 3 (s1) ◽

pp. 37-37

Author(s):

Jo Ellen Wilson ◽

Sarasota Mihalko ◽

Stephan Heckers ◽

Pratik P. Pandharipande ◽

Timothy D. Girard ◽

...

Keyword(s):

Survival Time ◽

Critically Ill ◽

Median Survival ◽

Critically Ill Patients ◽

Median Survival Time ◽

Rating Scale ◽

Brain Dysfunction ◽

Survival Times ◽

Dsm 5 ◽

Acute Brain Dysfunction

OBJECTIVES/SPECIFIC AIMS: Delirium, a form of acute brain dysfunction, characterized by changes in attention and alertness, is a known independent predictor of mortality in the Intensive Care Unit (ICU). We sought to understand whether catatonia, a more recently recognized form of acute brain dysfunction, is associated with increased 30-day mortality in critically ill older adults. METHODS/STUDY POPULATION: We prospectively enrolled critically ill patients at a single institution who were on a ventilator or in shock and evaluated them daily for delirium using the Confusion Assessment for the ICU and for catatonia using the Bush Francis Catatonia Rating Scale. Coma, was defined as a Richmond Agitation Scale score of −4 or −5. We used the Cox Proportional Hazards model predicting 30-day mortality after adjusting for delirium, coma and catatonia status. RESULTS/ANTICIPATED RESULTS: We enrolled 335 medical, surgical or trauma critically ill patients with 1103 matched delirium and catatonia assessments. Median age was 58 years (IQR: 48 - 67). Main indications for admission to the ICU included: airway disease or protection (32%; N=100) or sepsis and/or shock (25%; N=79. In the unadjusted analysis, regardless of the presence of catatonia, non-delirious individuals have the highest median survival times, while delirious patients have the lowest median survival time. Comparing the absence and presence of catatonia, the presence of catatonia worsens survival (Figure 1). In a time-dependent Cox model, comparing non-delirious individuals, holding catatonia status constant, delirious individuals have 1.72 times the hazards of death (IQR: 1.321, 2.231) while those with coma have 5.48 times the hazards of death (IQR: 4.298, 6.984). For DSM-5 catatonia scores, a 1-unit increase in the score is associated with 1.18 times the hazards of in-hospital mortality. Comparing two individuals with the same delirium status, an individual with a DSM-5 catatonia score of 0 (no catatonia) will have 1.178 times the hazard of death (IQR: 1.086, 1.278), while an individual with a score of 3 catatonia items (catatonia) present will have 1.63 times the hazard of death. DISCUSSION/SIGNIFICANCE OF IMPACT: Non-delirious individuals have the highest median survival times, while those who are comatose have the lowest median survival times after a critical illness, holding catatonia status constant. Comparing the absence and presence of catatonia, the presence of catatonia seems to worsen survival. Those individual who are both comatose and catatonic have the lowest median survival time.

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An Evaluation of Survival of Space Maintainers: A Six-year Follow-up Study

The Journal of Contemporary Dental Practice ◽

10.5005/jcdp-6-1-74 ◽

2005 ◽

Vol 6 (1) ◽

pp. 74-84 ◽

Cited By ~ 9

Author(s):

Ozlem Tulunoglu ◽

Tezer Ulusu ◽

Yasemin Genç

Keyword(s):

Survival Time ◽

Success Rate ◽

Median Survival ◽

Median Survival Time ◽

Age Groups ◽

Age Group ◽

Follow Up Study ◽

Different Types ◽

Lost To Follow Up

Abstract The aim of this study was to evaluate the median survival time of fixed and removable space maintainers related to age groups, gender, and their distribution in upper and lower dental arches. The adherence of patients to a periodic recall program and the success rate of different types of space maintainers related to different arches were also evaluated. This study included 663 patients aged between 4-15 years old that were treated between the years of 1997 and 2002. The patients were categorized into four main groups: lost to follow-up, failed, successful, and censored at the end of study. Three hundred forty-five space maintainers were considered lost to follow-up, 83 were considered failed, 206 successful, and 20 censored-at-end. The overall median survival time of the appliances was 6.51 months. Median survival time was 7.25 months in the 4-6 age group, 6.35 months in the 7-12 age group, and 7.0 months in the 13+ age groups. Median survival time was 5.76 months in girls and 7.11 months in boys. Median survival time of space maintainers was 7.17 months for maxilla and 6.69 months in the mandible. Median survival time was 5.25 months for space maintainers fabricated in both arches. Citation Tulunoglu Ö, Ulusu T, Genç Y. An Evaluation of Survival of Space Maintainers: A Six-year Follow-up Study J Contemp Dent Pract 2005 February;(6)1:074-084.

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Repeat decompression surgery for recurrent spinal metastases

Journal of Neurosurgery Spine ◽

10.3171/2010.3.spine08670 ◽

2010 ◽

Vol 13 (1) ◽

pp. 109-115 ◽

Cited By ~ 23

Author(s):

Ilya Laufer ◽

Andrew Hanover ◽

Eric Lis ◽

Yoshiya Yamada ◽

Mark Bilsky

Keyword(s):

Spinal Cord ◽

Survival Time ◽

Median Survival ◽

Spinal Cord Compression ◽

Median Survival Time ◽

Eastern Cooperative Oncology Group ◽

Cord Compression ◽

Decompression Surgery ◽

High Grade

Object In this paper, the authors' goal was to determine the outcome of reoperation for recurrent epidural spinal cord compression in patients with metastatic spine disease. Methods A retrospective chart review was conducted of all patients who underwent spine surgery at the Memorial Sloan-Kettering Cancer Center between 1996 and 2007. Thirty-nine patients who underwent reoperation of the spine at the level previously treated with surgery were identified. Only patients whose reoperation was performed because of tumor recurrence leading to high-grade epidural spinal cord compression or recurrence with no further radiation options were included in the study. Patients who underwent reoperations exclusively for instrumentation failure were excluded. All patients underwent additional decompression via a posterolateral approach without removal of the spinal instrumentation. Results Patients underwent 1–4 reoperations at the same level. A median survival time of 12.4 months was noted after the first reoperation, and a median survival time of 9.1 months was noted after the last reoperation. At last follow-up 22 (65%) of 34 patients were ambulatory at the time of last follow-up or death, and the median time between loss-of-ambulation and death was 1 month. Functional status was maintained or improved by one Eastern Cooperative Oncology Group grade in 97% of patients. A major surgical complication rate of 5% was noted. Conclusions Reoperation represents a viable option in patients with high-grade epidural spinal cord compression who have recurrent metastatic tumors at previously operated spinal levels. In carefully selected patients, reoperation can prolong ambulation and result in good functional and neurological outcomes.

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Evaluation of chemotherapy response between Paclitaxel-Cisplatin, Paclitaxel -Gemcitabine and Gemcitabine - Cisplatin among non - resectable lung cancer patients, A retrospective study in tertiary care hospital.

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v38i4.48977 ◽

2020 ◽

Vol 38 (4) ◽

pp. 172-175

Author(s):

Md Harun Or Rashid ◽

Quadrat E Elahi ◽

Md Ashraful Alam ◽

Fatima Sarker

Keyword(s):

Lung Cancer ◽

Survival Rate ◽

Survival Time ◽

Cancer Patients ◽

Median Survival ◽

Median Survival Time ◽

Chemotherapy Response ◽

Care Hospital ◽

Lung Cancer Patients ◽

Significant Difference

Background: To compare the survival rate of paclitaxel plus cisplatin (PC arm), paclitaxel plus gemcitabine (PG arm) and gemcitabine plus cisplatin (GC arm) in chemotherapy patients with non resectable lung cancer. Methods: This was a retrospective observational study to evaluate chemotherapy response among non resectable lung cancer patients with their survival at cancer center CMH, Dhaka since 01 July 2013 to 31 March 2015. One hundred fifty-four (154) non resectable lung cancer patients were randomly divided into three groups, 50 patients in PC arm, 51 patients in PG arm and 53 patients in GC arm. In PC arm paclitaxel 175 mg/m2 (day 1) with cisplatin 75mg/m2 (day 1), in PG arm Paclitaxel 175 mg/m2 (day 1) with gemcitabine 1000 mg/m2 (days 1 and 8) and in GC arm gemcitabine 1000 mg/m2 (days 1 and 8) with cisplatin 100mg/m2 (day 1). Results: Patients characteristics were similar between the three groups. The overall response rate was 40% in the PC arm,43.1% in the PG arm, 43.4% in the GC arm. The median survival time in PC arm was 8.5 months, in PG arm was 8.8 months, in GC arm was 9.2 months. The major side effect was myelosuppression which accounts 71% patients. The average treatment costs were 57% and 30% lower in PC arm as compared with GC and PG arm respectively. Conclusion: The median survival time, disease free survival time and 1-year survival rate in PC, PG, GC arms without significant difference. Treatment were well tolerable; quality of life parameter was mostly similar but paclitaxel with cisplatin was most cost effective than others chemotherapy regimen. J Bangladesh Coll Phys Surg 2020; 38(4): 172-175

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The effect of chronic diseases on the clinical effect and survival period of patients with solid tumor treated with UMIPIC.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e16532 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e16532-e16532

Author(s):

Shanshan Cui ◽

Yanping Liu ◽

Yanfei Wu ◽

Wei Shang ◽

Wei Han ◽

...

Keyword(s):

Chronic Disease ◽

Side Effects ◽

Survival Time ◽

Cancer Patients ◽

Chronic Diseases ◽

Median Survival ◽

Median Survival Time ◽

Adverse Reactions ◽

Clinical Effect ◽

Patients With Cancer

e16532 Background: To observe the effect of chronic disease condition on the therapeutic effect and survival period of cancer patients treated with UMIPIC. Methods: 2594 cancer patients in our hospital from January 2011 to December 2015 who received UMIPIC for the study objects. 576 cases with chronic diseases, 2018 without chronic disease, 840 with lung cancer, 712 with esophageal cancer, 254 with liver cancer, 108 with pancreatic cancer, 93 with gastric cancer, 587 with other cancers. They signed the consent for treatment, evaluated the efficacy, followed up to the clinical effect, adverse reactions, survival data of patients. Results: The side effects of the chronic disease patients with cancer after UMIPIC therapy is fever at 26.56%, pain at 15.10%, the second was hemoglobin reduction 16.48%, leucopenia 5.27%, liver function damage 2.67%, thrombocytopenia 2.45%, nausea 2.26%, vomiting 1.39%, neurotoxicity and hair loss of less than 0.20%, while cancer patients without chronic disease after UMIPIC therapy, side effect is fever at 32.37%, pain at14.87%, hemoglobin reduction 13.26%, leucopenia 6.09%, nausea 2.73%, thrombocytopenia 2.6% 3%, liver function damage 1.77%, vomiting 1.73%, kidney function damage 0.89%, neurotoxicity and hair loss were lower than 0.20%; there is only fever difference in the two groups (P < 0.05).There was no significant difference in other adverse reactions. This may be due to the immunity of normal patients was stronger than that of chronic patients. It was found that the clinical benefit rate of 90.91% in patients with chronic diseases was significantly lower than 93.44% in patients without chronic diseases (P = 0.021); after follow-up, we found that the mean survival time of patients with chronic diseases was 22.149 months, median survival time was 10.300 months, while median survival time of patients without chronic diseases was 22.940 months, median survival time was 11.200 months, and the survival rates of patients without chronic diseases for 1, 2, 3 and 5-year were 48.94%, 29.97%, 25.19%, and 25.18% respectively, it is significantly higher than those of patients with chronic diseases (43.19%, 22.33%, 18.37% and 16.04%) (P<0.05). Conclusions: The survival time and survival rate of the patients without chronic diseases are higher than those of the patients with chronic diseases. The side effects of chronic diseases on the patients with cancer treated with UMIPIC are not significant different except for fever. The patients with chronic diseases can safely receive UMIPIC treatment.

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Primary Squamous Cell Carcinomas Arising in Intracranial Epidermoid Cysts: A Series of Nine Cases and Systematic Review

Frontiers in Oncology ◽

10.3389/fonc.2021.750899 ◽

2021 ◽

Vol 11 ◽

Author(s):

Pengcheng Zuo ◽

Tao Sun ◽

Yi Wang ◽

Yibo Geng ◽

Peng Zhang ◽

...

Keyword(s):

Survival Time ◽

Median Survival ◽

Squamous Cell ◽

Median Survival Time ◽

Postoperative Radiotherapy ◽

Squamous Cell Carcinomas ◽

Epidermoid Cysts ◽

Pubmed Database ◽

Intracranial Epidermoid

ObjectivePrimary squamous cell carcinomas (PSCCs) arising in intracranial epidermoid cysts (IECs) are very rare, and their management and prognostic factors remain unclear. This study aimed to enunciate the clinical features and suggest a treatment protocol based on cases from the literature and the cases from our institution.MethodsThe clinicoradiological data were obtained from nine patients with PSCCs arising in IECs, who underwent surgical treatment at Beijing Tiantan Hospital between July 2012 and June 2018. We also searched the PubMed database using the keywords “epidermoid cyst(s)” or “epidermoid tumor(s)” combined with “malignant” or “malignancy” or “intracranial” or “brain” or “squamous cell carcinoma” between 1960 and 2020. Risk factors for overall survival (OS) were evaluated in the pooled cohort.ResultsThe mean age of our cohort was 51.2 ± 8.3 years (range: 39–61 years), which included eight males and one female. Gross total resection (GTR) was achieved in three patients, while non-GTR was achieved in six patients. Radiotherapy was administered to five patients. After a median follow-up of 16.7 ± 21.6 months (range: 3–72 months), eight patients died with a mean OS time of 9.75 ± 6.6 months (range: 3–23 months). In the literature between 1965 and 2020, 45 cases of PSCCs arising in IECs were identified in 23 males and 22 females with a mean age of 55.2 ± 12.4 years. GTR, non-GTR, and biopsy were achieved in six (13.3%), 36 (80%), and three (6.7%) cases, respectively. After a mean follow-up of 12.7 ± 13.4 months (range: 0.33–60 months), 54.1% (20/37) patients died, and recurrence occurred in 53.6% (15/28) patients. A multivariate analysis demonstrated that postoperative radiotherapy (p = 0.002) was the only factor that favored OS. The Kaplan–Meier analysis showed that, compared with no radiotherapy (median survival time: 4 months), radiotherapy (median survival time: 24 months) had significantly prolonged OS (p = 0.0011), and GTR could not improve OS (p = 0.5826), compared with non-GTR. The 1-year OS of patients with or without radiotherapy was 72.5% or 18.2%, respectively.ConclusionMalignant transformation of IEC into PSCC was prevalent in elderly patients, with slight male predominance. GTR of previous benign IECs is recommended. For remnant benign IECs, close follow-up should be performed. Postoperative radiotherapy for PSCCs could bring survival benefit. GTR of these malignant intracranial tumors is difficult when they involve important brain structures. Future studies with larger cohorts are necessary to verify our findings.

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Influence of chemiotherapeutic protocol and neuroendocrine differentiation on metastatic non-small cell lung cancer treatment results

Vojnosanitetski pregled ◽

10.2298/vsp0709591t ◽

2007 ◽

Vol 64 (9) ◽

pp. 591-596 ◽

Cited By ~ 3

Author(s):

Ilija Tomic ◽

Marina Petrovic ◽

Goran Plavec ◽

Srbislav Ilic

Keyword(s):

Survival Time ◽

Median Survival ◽

Median Survival Time ◽

Therapeutic Response ◽

Neuroendocrine Differentiation ◽

Survival Period ◽

Small Cell Lung ◽

Metastatic Nsclc ◽

One Year

Background/Aim. In 40-50% of patients with non-small cell lung cancer (NSCLC) at the time of making a diagnosis, the disease is yet at IIIb and IV stage. Standard in the treatment of these patient is the application of systemic chemiotherapy based on CIS/Carboplatin preparations. The aim of this study was to determine the influence of two different chemiotherapeutic protocols and neuroendocrine differentiation on treatment response and survival in patients with metastatic NSCLC. Methods. We examined 85 patients with metastatic NSCLC, of which 51 with stage IIIb, and 34 with stage IV of the disease. The histologic diagnosis of NSCLC was determined by tissue assays using hematoxylin eosin method. Neuroendocrine differentiation was determined by immunohistochemical analysis of neuron- specific enolase (NSE), chromogranin A, and synapthophysin expression using monoclonal mouse anti- human bodies (DAKO, Denmark). According to chemiotherapeutic protocol, the patients were randomly assigned into combined Taxol + Cisplatin group (Tax + Cis, n = 35), and Cyclophosphamide + Etoposide + Carboplatin group (CEP, n = 50). The treatment was conducted within 4-6 chemiotherapeutic cycles. The efficacy was assessed after the therapy regimen and median survival time was assessed after the randomization. Results. A total of 31 (36.47%) patients had a favourable therapeutic response, both partial and complete response (54.2% in the Tax + Cis group and 24% in CEP group of patients, respectively, p < 0.001). The median survival time in both groups was 13.1 months (15.3 months in the Tax + Cis group and 10.6 months in the CEP group, respectively, p < 0.001). A one-year follow-up survival period was confirmed in 40% of patients (60% only in the Tax + Cis group). A total of 23 (27.05%) patients with metastatic NSCLC had neuroendocrine differentiation. The disease progression or stable disease was noted only in patient with NSCLC without neuroendocrine differentiation (n = 42, 67.7%, p < 0.001). The median survival time in patients with NSCLC and neuroendocrine differentiation was 14.8 months, without neuroendocrine differentiation 10.7 months (p < 0.001). The patients with NSCLC and neuroendocrine differentiation in the CEP group had a longer one-year follow-up survival period than patients in Tax + Cis group (p < 0.001). In Tax-Cis group of patients, there was no significant difference in one-year follow-up survival period with neuroendocrine differentiation. Conclusion. Better therapeutic response and longer median survival time in metastatic NSCLC was obtained using Tax + Cis as compared to CEP protocol. Similar effect was noted using CEP protocol in patients with NSCLC and neuroendocrine differentiation. .

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Liver metastases of colorectal carcinoma: Prospective study on the use of transarterial chemoembolization (TACE)

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.4062 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 4062-4062

Author(s):

T. J. Vogl ◽

T. Gruber ◽

S. Zangos ◽

J. O. Balzer

Keyword(s):

Colorectal Cancer ◽

Survival Rate ◽

Liver Metastases ◽

Survival Time ◽

Cancer Patients ◽

Median Survival ◽

Local Control ◽

Median Survival Time ◽

Kaplan Meier ◽

Colorectal Cancer Patients

4062 Background: To evaluate the efficacy of chemoembolization (TACE) in the treatment of liver metastases in colorectal cancer patients concerning local control and survival. Methods: 207 patients with liver metastases of colorectal cancer were treated with repeated TACE in 4-week intervals. In total, 1,307 chemoembolizations were performed with a mean of 6.3 sessions per patient. At the time of first chemoembolization the average age of the patients was 68.8 years (range, 39.4–83.5 years). 158 patients were treated palliatively, 35 symptomatically and 14 patients neoadjuvantly. The chemotherapy consisted of Mitomycin C with/without Gemcitabin; embolization was performed with Lipiodol and starch microspheres for vessel occlusion. Tumor response was evaluated by magnetic resonance imaging (MRI). The change in size was calculated and the response was evaluated according to the RECIST criteria. Survival rates from the first diagnosis and from the first TACE session were both calculated according to the Kaplan-Meier method to obtain the median survival. Results: While 70% of the patients showed multiple metastases, 6% had 1 metastasis, 5.8% had 2 metastases and 18.2% had 3 to 4 metastases. Lesion size and number before, during and after treatment were assessed to deduce the morphological response. Local control results according to the RECIST criteria were as follows: partial response 12% of patients, stable disease in 51% and progressive disease in 37%. The 1-year survival rate after TACE was 62%, but the 2-year survival rate had been reduced to 38%. The median survival time from the date of diagnosis of metastases was 3.4 years (according to Kaplan-Meier), the median survival time from the start of TACE treatment was 1.34 years. The median survival time of the palliative group was 1.4 years, of the symptomatic group 0.8 years and of the neoadjuvant group 1.5 years. Conclusions: TACE is an effective minimal-invasive therapy for neoadjuvant, symptomatic or palliative treatment of liver metastases in colorectal cancer patients. No significant financial relationships to disclose.

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