Case Story from Denmark: TACE in Frankfurt for Liver Metastases from Prostate Cancer
Miguel is a patient from Denmark who had already been through the standard milestones of advanced prostate cancer treatment. He had undergone prostate surgery and received hormonal therapy before. For a period, the disease appeared to be controlled. Subsequently, new findings emerged that altered both the plan and the urgency.
Progression Beyond the Prostate
As part of ongoing monitoring, the patient underwent a PET-CT scan. The results showed metastatic changes in the liver, including a lesion measuring 26 mm. The scan also identified several enlarged lymph nodes along the left iliac vessels.
The pattern suggested progression and raised an important question. Was this still behaving like a typical prostate adenocarcinoma, or had the biology shifted?
New Biopsy Confirmation
To clarify the nature of the liver lesion, Miguel underwent a liver biopsy. Pathology confirmed that the lesion represented a metastasis; however, histology was critical. It was reported as a small-cell neuroendocrine carcinoma.
For patients with metastatic prostate cancer, neuroendocrine transformation is a major clinical turning point because it often indicates a more aggressive disease behavior and can require a different treatment strategy than hormone-driven disease.
Liver-Directed Approach
Miguel was diagnosed with a distinct liver metastasis that showed aggressive characteristics. This required a targeted treatment plan focused on the liver lesion.
Systemic therapy is important for managing metastatic disease. However, prioritizing local control can be beneficial, especially when a significant tumor is present in the liver. This approach can help reduce the tumor size or slow its growth. Therefore, transarterial chemoembolization (TACE) was recommended as a potential treatment option.
Transarterial chemoembolization (TACE) is an interventional oncology procedure that delivers chemotherapy directly into the arteries supplying a liver tumor. By administering the drugs directly to the tumor's blood supply and then blocking these vessels, the treatment maximizes the chemotherapy's effect within the liver while minimizing its systemic circulation.
In Miguel's case, the TACE procedure utilized the drugs Mitomycin and Cisplatin. The goal was to perform a targeted, locoregional treatment of the liver metastasis, conducted by a team of specialists in image-guided tumor therapies.
Treatment in Frankfurt
Miguel wanted a center with extensive experience in liver-directed procedures and interventional radiology. He also needed clear guidance to care, because once the biopsy confirmed a more aggressive cancer, time and coordination mattered.
After checking Miguel’s medical information at a few leading cancer centres, his case was matched with the team at University Hospital Frankfurt am Main in Germany. Here, the treatment was planned under the care of Prof. Dr. Thomas J. Vogl.
He underwent transarterial chemoembolization in two sessions. The sessions were conducted over two days as separate visits, allowing careful delivery of therapy and monitoring between treatments.
For the patient, the next phase included reassessment, follow-up imaging, and continued coordination of systemic management appropriate for the neuroendocrine disease's behavior.