Safety and Efficacy of Hepatic Artery Embolization in Treating Solitary Fibrous Tumor Metastatic to the Liver

Abstract

The aim of this study was to evaluate safety and survival following hepatic artery embolization (HAE) for metastatic solitary fibrous tumor (SFT) in the liver. All patients with SFT metastatic to liver treated with HAE were retrospectively analyzed. Tumor response was evaluated using mRECIST. Objective response, overall survival (OS), and progression-free survival (PFS) were evaluated using Kaplan–Meier and multivariate Cox proportional hazard ratio. Adverse events were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 5.0. Twelve patients (6 males and 6 females, mean age: 42.5 ± 13 years; 24–65) were treated with 33 embolizations. Anatomical sites of origin for SFT were the head and neck (n = 6; 50%), pelvis (n = 2), pleura (n = 2), retroperitoneal (n = 1), and thigh (n = 1). The median follow-up from first HAE was 4.5 years (3–7.9). 84% of the patients showed objective response [42% complete response (CR) plus 42% partial response (PR)] to HAE by mRECIST (95% CI, 60–99%). Patients with CR to HAE had significantly higher OS compared to others (p<0.02). The postembolization median OS was 4 years (95% CI, 2.3–5.2), and mean PFS, for intra- or extrahepatic progression of disease, was 6 months (95%, CI, 3.2–7.1). One patient developed pneumonia/sepsis and died 27 days postembolization, possibly not directly related to embolization. No grade III or IV adverse events were identified in the remaining patients. In conclusion, HAE for metastatic liver SFT is a relatively safe treatment option with high response rate and should be considered as a treatment option for metastatic liver SFT. In our cohort of patients with metastatic SFT to the liver, we observed a median OS of 4 years following HAE. Further studies are needed to confirm the efficacy of HAE.