PMID- 35380246
OWN - NLM
STAT- MEDLINE
DCOM- 20220517
LR  - 20221008
IS  - 2366-0058 (Electronic)
VI  - 47
IP  - 6
DP  - 2022 Jun
TI  - Trans-arterial embolization of renal cell carcinoma: a systematic review and 
      meta-analysis.
PG  - 2238-2243
LID - 10.1007/s00261-022-03502-8 [doi]
AB  - PURPOSE: To evaluate if trans-arterial embolization (TAE) of the primary tumor in 
      patients with renal cell carcinoma (RCC) improves symptomatology such as pain and 
      hematuria or oncologic outcomes such as progression-free survival (PFS) and 
      overall survival (OS). MATERIALS AND METHODS: The systematic review search 
      included PubMed, Ovid/MEDLINE, and Embase for full-text English articles 
      including randomized and non-randomized prospective trials as well as prospective 
      and retrospective case series. To be included, prospective trials needed >/= 25 
      patients in each arm while case series and retrospective chart reviews required 
      at least two patients. Evaluated outcomes included PFS, OS, change in tumor size, 
      improvements in pain, improvements in hematuria, and adverse events (AEs). 
      RESULTS: 1327 articles were retrieved and screened. Nine studies met inclusion 
      criteria (retrospective case series, n = 8; non-randomized prospective trial, 
      n = 1) which included 237 patients (M = 156 (65.8%); F = 56 (23.6%); gender 
      unreported = 25 (10.5%); mean age: 69.4 (range: 38-87)) with a mean tumor 
      diameter of 9.3 cm (5.2-10.5). When reported, the TNM stages were stage I 
      (n = 10), II (n = 18), III (n = 36), and IV (n = 121). 60 patients were treated 
      for pain and hematuria. After TAE, pain improved in 59 patients (98.3%) and 
      hematuria improved in 57 patients (95%). A meta-analysis for improvements in pain 
      and hematuria demonstrated an event rate of pain improvement of 0.952 
      (0.788-0.990; p < 0.001) and an event rate for hematuria improvement of 0.923 
      (0.809-0.971; p < 0.001). Median OS ranged from 1 to 39 months but only one study 
      reported PFS (10.5 months). Only one study demonstrated a statistically 
      significant improvement in OS with TAE when compared with patients that did not 
      undergo TAE (p = 0.02). A reduction in tumor size was only achieved in 17 
      patients (17/49; 34.7%) limiting evaluation. AEs included fever (n = 115/237; 
      48.5%), flank pain (n = 72/237; 30.4%), nausea (n = 58/237; 24.5%), hematuria 
      (n = 12/237; 5.1%), hypertension (n = 12/237; 5.1%), reduced GFR (n = 6/237; 
      2.5%), hematoma (n = 6/237,2.5%), and ileus (n = 3/237; 1.3%). CONCLUSION: TAE 
      monotherapy of the primary tumor in patients with RCC improves symptomatology 
      such as pain and hematuria with an acceptable safety profile.
CI  - (c) 2022. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Wright, Bryan
AU  - Wright B
AD  - Oklahoma State University Center for Health Sciences College of Osteopathic 
      Medicine, Tulsa, OK, USA.
FAU - Johnson, Bradley S
AU  - Johnson BS
AD  - Oklahoma State University Center for Health Sciences College of Osteopathic 
      Medicine, Tulsa, OK, USA.
FAU - Vassar, Matt
AU  - Vassar M
AD  - Oklahoma State University Center for Health Sciences College of Osteopathic 
      Medicine, Tulsa, OK, USA.
FAU - Saidian, Ava
AU  - Saidian A
AD  - Department of Urology, University of Alabama at Birmingham, Birmingham, AL, USA.
FAU - Rais-Bahrami, Soroush
AU  - Rais-Bahrami S
AD  - Department of Urology, University of Alabama at Birmingham, Birmingham, AL, USA.
AD  - Department of Radiology, University of Alabama at Birmingham, 619 19th St S, NHB 
      623, Birmingham, AL, USA.
FAU - Gunn, Andrew J
AU  - Gunn AJ
AUID- ORCID: 0000-0001-9081-446X
AD  - Department of Radiology, University of Alabama at Birmingham, 619 19th St S, NHB 
      623, Birmingham, AL, USA. agunn@uabmc.edu.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20220405
PL  - United States
TA  - Abdom Radiol (NY)
JT  - Abdominal radiology (New York)
JID - 101674571
SB  - IM
MH  - Aged
MH  - *Carcinoma, Renal Cell/diagnostic imaging/pathology/therapy
MH  - Female
MH  - Hematuria/therapy
MH  - Humans
MH  - *Kidney Neoplasms/diagnostic imaging/pathology/therapy
MH  - Male
MH  - Pain
MH  - Prospective Studies
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Embolization
OT  - Hematuria
OT  - Meta-analysis
OT  - Pain
OT  - Renal cell carcinoma
EDAT- 2022/04/06 06:00
MHDA- 2022/05/18 06:00
CRDT- 2022/04/05 12:02
PHST- 2022/02/04 00:00 [received]
PHST- 2022/03/17 00:00 [accepted]
PHST- 2022/03/15 00:00 [revised]
PHST- 2022/04/06 06:00 [pubmed]
PHST- 2022/05/18 06:00 [medline]
PHST- 2022/04/05 12:02 [entrez]
AID - 10.1007/s00261-022-03502-8 [pii]
AID - 10.1007/s00261-022-03502-8 [doi]
PST - ppublish
SO  - Abdom Radiol (NY). 2022 Jun;47(6):2238-2243. doi: 10.1007/s00261-022-03502-8. 
      Epub 2022 Apr 5.